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Airway responsiveness to methacholine and incidence of COPD : an international prospective cohort study

Marcon, Alessandro and Locatelli, Francesca and Keidel, Dirk and Beckmeyer-Borowko, Anna B. and Cerveri, Isa and Dharmage, Shyamali C. and Fuertes, Elaine and Garcia-Aymerich, Judith and Heinrich, Joachim and Imboden, Medea and Janson, Christer and Johannessen, Ane and Leynaert, Bénédicte and Pascual Erquicia, Silvia and Pesce, Giancarlo and Schaffner, Emmanuel and Svanes, Cecilie and Urrutia, Isabel and Jarvis, Deborah and Probst-Hensch, Nicole M. and Accordini, Simone and Ageing Lungs in European Cohorts study, . (2018) Airway responsiveness to methacholine and incidence of COPD : an international prospective cohort study. Thorax, 73 (9). pp. 825-832.

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Abstract

It has been debated, but not yet established, whether increased airway responsiveness can predict COPD. Recognising this link may help in identifying subjects at risk.; We studied prospectively whether airway responsiveness is associated with the risk of developing COPD.; We pooled data from two multicentre cohort studies that collected data from three time points using similar methods (European Community Respiratory Health Survey and Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults). We classified subjects (median age 37 years, 1st-3rd quartiles: 29-44) by their level of airway responsiveness using quintiles of methacholine dose-response slope at the first examination (1991-1994). Then, we excluded subjects with airflow obstruction at the second examination (1999-2003) and analysed incidence of COPD (postbronchodilator FEV; 1; /FVC below the lower limit of normal) at the third examination (2010-2014) as a function of responsiveness, adjusting for sex, age, education, body mass index, history of asthma, smoking, occupational exposures and indicators of airway calibre.; We observed 108 new cases of COPD among 4205 subjects during a median time of 9 years. Compared with the least responsive group (incidence rate 0.6 per 1000/year), adjusted incidence rate ratios for COPD ranged from 1.79 (95% CI 0.52 to 6.13) to 8.91 (95% CI 3.67 to 21.66) for increasing airway responsiveness. Similar dose-response associations were observed between smokers and non-smokers, and stronger associations were found among subjects without a history of asthma or asthma-like symptoms.; Our study suggests that increased airway responsiveness is an independent risk factor for COPD. Further research should clarify whether early treatment in patients with high responsiveness can slow down disease progression.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Chronic Disease Epidemiology > Genetic Epidemiology of Non-Communicable Diseases (Probst-Hensch)
03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Genetic Epidemiology of Non-Communicable Diseases (Probst-Hensch)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Biostatistics > Biostatistics - Frequency Modelling (Schindler)
UniBasel Contributors:Keidel, Dirk and Imboden, Medea and Schaffner, Emmanuel and Probst-Hensch, Nicole
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:British Medical Association
ISSN:0040-6376
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:11 Sep 2018 13:12
Deposited On:11 Sep 2018 13:12

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