Lung Function Trajectories From Childhood To Young Adulthood; A Peek Into The Future Of Lung Health?
Saturday, March 3, 2018: 2:15 PM
S330AB (Convention Center)
Syed H. Arshad, DM, FRCP, , , , , , , ,
RATIONALE: Using the Isle of Wight Birth Cohort (IOWBC), we investigated lung function trajectories in adolescence and early adult life to identify those at a higher risk of lung function deficit in later adult life.

METHODS: The IOWBC is a population based cohort (n=1456), recruited in 1989- 90 and assessed at birth, 1, 2, 4, 10, 18 and 26 years for asthma and allergic diseases and environmental exposures. Spirometric lung function was measured at 10 (n=981), 18 (n=839) and 26 years (n=555) using standardized methodology.

RESULTS: The pre-bronchodilator mean forced vital capacity (FVC) increased with age (10 years: 2.29L, 18 years: 4.62L and 26 years: 4.83L; p<0.001), whereas forced expiratory volume in one second (FEV1) increased between 10 and 18 years (2.03L to 4.01; p<0.001), while declining to 3.83L at 26 years (P<0.001); resulting in a reduction in FEV1/FVC ratio from 0.87 at 10 years to 0.78 at 26 years (p<0.001). There was a similar reduction in mid-expiratory flows (FEF25-75) from 18 years to 26 years (4.44L to 3.76L; p<0.001). Post-bronchodilator values showed the same pattern and were all statistically significant (p<0.001).

CONCLUSIONS: The decline in indices of lung function reflecting airway diameter (FEV1, FEV1/FVC ratio, and FEF25-75) occurs very early in adult life. This is not fully responsive to bronchodilator and indicates that adolescent and early adult life is a crucial period for long term lung health. Factors determining this early decline should be sought.