کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
6064851 | 1201865 | 2014 | 11 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Asthma and lower airway diseaseCan an airway challenge test predict respiratory diseases? AÂ population-based international study Asthma and lower airway diseaseCan an airway challenge test predict respiratory diseases? AÂ population-based international study](/preview/png/6064851.png)
BackgroundEvidence on the longitudinal association of airway responsiveness with respiratory diseases is scarce. The best indicator of responsiveness is still undetermined.ObjectiveWe investigated the association of airway responsiveness with the incidence of asthma, chronic obstructive pulmonary disease (COPD), and allergic rhinitis.MethodsWe studied 3851 subjects who underwent spirometry and methacholine challenge tests both at baseline (1991-1993), when they were 20 to 44 years old, and at follow-up (1999-2002) in the European Community Respiratory Health Survey. Airway responsiveness was defined based on the methacholine dose-response slope on both occasions. Incidence rate ratios for the association of airway responsiveness with disease occurrence were computed by using Poisson regression.ResultsWith respect to reference (slope of the fourth quintile or greater), subjects with the greatest degree of airway responsiveness (slope less than the first quintile) showed the greatest risk of developing asthma, COPD, and allergic rhinitis (incidence rate ratios of 10.82, 5.53, and 4.84, respectively; all PÂ < .01). AÂ low slope predicted disease occurrence, even in subjects who did not reach a 20% decrease in FEV1 at the cumulative dose of 1 mg of methacholine (PD20 >1 mg). AÂ decrease in slope over time was an independent predictor of disease risk.ConclusionAirway responsiveness predicted new-onset asthma, COPD, and allergic rhinitis. Our study supports the use of a continuous noncensored indicator of airway responsiveness, such as the slope of the methacholine dose-response curve, in clinical practice and research because it showed clear advantages over PD20.
Journal: Journal of Allergy and Clinical Immunology - Volume 133, Issue 1, January 2014, Pages 104-110.e4