Citation:
Kalhan R, Dransfield MT, Colangelo LA, Cuttica MJ, Jacobs DR, Thyagarajan B, Estepar RSJ, Harmouche R, Onieva Onieva J, Ash SY, Okajima Y, Iribarren C, Sidney S, Lewis CE, Mannino DM, Liu K, Smith LJ, Washko GR.
Respiratory Symptoms in Young Adults and Future Lung Disease. The CARDIA Lung Study. Am J Respir Crit Care Med 2018;197(12):1616-1624.
Date Published:
2018 Jun 15Abstract:
RATIONALE: There are limited data on factors in young adulthood that predict future lung disease.
OBJECTIVES: To determine the relationship between respiratory symptoms, loss of lung health, and incident respiratory disease in a population-based study of young adults.
METHODS: We examined prospective data from 2,749 participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who completed respiratory symptom questionnaires at baseline and 2 years later and repeated spirometry measurements over 30 years.
MEASUREMENTS AND MAIN RESULTS: Cough or phlegm, episodes of bronchitis, wheeze, shortness of breath, and chest illnesses at both baseline and Year 2 were the main predictor variables in models assessing decline in FEV and FVC from Year 5 to Year 30, incident obstructive and restrictive lung physiology, and visual emphysema on thoracic computed tomography scan. After adjustment for covariates, including body mass index, asthma, and smoking, report of any symptom was associated with -2.71 ml/yr excess decline in FEV (P < 0.001) and -2.18 in FVC (P < 0.001) as well as greater odds of incident (prebronchodilator) obstructive (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.24-2.14) and restrictive (OR, 1.40; 95% CI, 1.09-1.80) physiology. Cough-related symptoms (OR, 1.56; 95% CI, 1.13-2.16) were associated with greater odds of future emphysema.
CONCLUSIONS: Persistent respiratory symptoms in young adults are associated with accelerated decline in lung function, incident obstructive and restrictive physiology, and greater odds of future radiographic emphysema.