Trajectories of asthma and allergies from 7 years to 53 years and associations with lung function and extrapulmonary comorbidity profiles: a prospective cohort study
Longitudinal trajectories of asthma and allergies from childhood to adulthood might be differentially associated with lung function and chronic obstructive pulmonary disease (COPD), but associations with extrapulmonary comorbidities have not been well investigated. We aimed to assess these trajector...
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| Veröffentlicht in: | The lancet respiratory medicine 2021-04, Vol.9 (4), p.387-396 |
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| creator | Bui, Dinh S Lodge, Caroline J Perret, Jennifer L Lowe, Adrian Hamilton, Garun S Thompson, Bruce Giles, Graham Tan, Daniel Erbas, Bircan Pirkis, Jane Cicuttini, Flavia Cassim, Raisa Bowatte, Gayan Thomas, Paul Garcia-Aymerich, Judith Hopper, John Abramson, Michael J Walters, Eugene H Dharmage, Shyamali C |
| description | Longitudinal trajectories of asthma and allergies from childhood to adulthood might be differentially associated with lung function and chronic obstructive pulmonary disease (COPD), but associations with extrapulmonary comorbidities have not been well investigated. We aimed to assess these trajectories and examine their associations with lung function outcomes and profiles of comorbidities.
In this prospective cohort study, data for asthma and related allergic conditions (ie, eczema, hay fever, and food allergy) were prospectively collected from the Tasmanian Longitudinal Health Study for participants aged 7–53 years originally recruited in Tasmania, Australia. All surviving individuals in the database with contact details were invited in the most recent follow-up (mean age 53 years). There were no exclusion criteria. With use of latent class analysis, we identified longitudinal trajectories of asthma and allergic conditions from 7–53 years, and profiles of self-reported extrapulmonary conditions recorded at 53 years. The associations between asthma and allergy trajectories and morbidity profiles and lung function at 53 years were investigated with regression models.
Between Sept 3, 2012, and Nov 8, 2016, of 6128 individuals invited, 3609 (58·9%) individuals were enrolled. We identified five asthma and allergy trajectories: minimal and least asthma and allergies (n= 1767 [49·0%]); late-onset hay fever, no asthma (n=1065 [29·5%]); early-onset remitted asthma and allergies (n=236 [6·5%]); late-onset asthma and allergies (n=317 [8·8%]); and early-onset persistent asthma and allergies (n=224 [6·2%]); and four profiles of extrapulmonary morbidities: minimal or least disease (n=2206 [61·1%]); dominant mental health disorders (n=861 [23·9%]); dominant cardiovascular diseases or risks (n=424 [11·7%]); and multiple disorders (n=117 [3·2%]). The late-onset asthma and allergies trajectory was predominantly associated with the multiple disorders profile (relative risk ratio 3·3 [95% CI 1·9–5·9]), whereas the other asthma and allergy trajectories were associated only with the dominant mental health disorders profile. Both spirometrically defined and clinical COPD were most strongly associated with the early-onset persistent asthma and allergies trajectory (odds ratio [OR] 5·3 [95% CI 3·2–8·6]) and also with the late-onset asthma and allergies trajectory (OR 3·8 [2·4–6·1]).
Distinct longitudinal trajectories of asthma and allergic disease from childhood to 53 years are |
| doi_str_mv | 10.1016/S2213-2600(20)30413-6 |
| format | Article |
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In this prospective cohort study, data for asthma and related allergic conditions (ie, eczema, hay fever, and food allergy) were prospectively collected from the Tasmanian Longitudinal Health Study for participants aged 7–53 years originally recruited in Tasmania, Australia. All surviving individuals in the database with contact details were invited in the most recent follow-up (mean age 53 years). There were no exclusion criteria. With use of latent class analysis, we identified longitudinal trajectories of asthma and allergic conditions from 7–53 years, and profiles of self-reported extrapulmonary conditions recorded at 53 years. The associations between asthma and allergy trajectories and morbidity profiles and lung function at 53 years were investigated with regression models.
Between Sept 3, 2012, and Nov 8, 2016, of 6128 individuals invited, 3609 (58·9%) individuals were enrolled. We identified five asthma and allergy trajectories: minimal and least asthma and allergies (n= 1767 [49·0%]); late-onset hay fever, no asthma (n=1065 [29·5%]); early-onset remitted asthma and allergies (n=236 [6·5%]); late-onset asthma and allergies (n=317 [8·8%]); and early-onset persistent asthma and allergies (n=224 [6·2%]); and four profiles of extrapulmonary morbidities: minimal or least disease (n=2206 [61·1%]); dominant mental health disorders (n=861 [23·9%]); dominant cardiovascular diseases or risks (n=424 [11·7%]); and multiple disorders (n=117 [3·2%]). The late-onset asthma and allergies trajectory was predominantly associated with the multiple disorders profile (relative risk ratio 3·3 [95% CI 1·9–5·9]), whereas the other asthma and allergy trajectories were associated only with the dominant mental health disorders profile. Both spirometrically defined and clinical COPD were most strongly associated with the early-onset persistent asthma and allergies trajectory (odds ratio [OR] 5·3 [95% CI 3·2–8·6]) and also with the late-onset asthma and allergies trajectory (OR 3·8 [2·4–6·1]).
Distinct longitudinal trajectories of asthma and allergic disease from childhood to 53 years are associated with different profiles of extrapulmonary comorbidities and varying risk of COPD. These findings can inform a personalised approach in clinical guidelines and management focusing on treatable traits. Comorbidity profiles are a new target for early identification and intervention.
National Health and Medical Research Council of Australia, EU's Horizon 2020, The University of Melbourne, Clifford Craig Medical Research Trust of Tasmania, The Victorian, Queensland & Tasmanian Asthma Foundations, The Royal Hobart Hospital, Helen MacPherson Smith Trust, and GlaxoSmithKline.</description><identifier>ISSN: 2213-2600</identifier><identifier>EISSN: 2213-2619</identifier><identifier>DOI: 10.1016/S2213-2600(20)30413-6</identifier><identifier>PMID: 33217367</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Age of Onset ; Asthma - diagnosis ; Asthma - epidemiology ; Child ; Comorbidity ; Female ; Humans ; Hypersensitivity - diagnosis ; Hypersensitivity - epidemiology ; Longitudinal Studies ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonary Disease, Chronic Obstructive - epidemiology ; Self Report - statistics & numerical data ; Severity of Illness Index ; Spirometry - statistics & numerical data ; Tasmania - epidemiology ; Young Adult</subject><ispartof>The lancet respiratory medicine, 2021-04, Vol.9 (4), p.387-396</ispartof><rights>2021 Elsevier Ltd</rights><rights>Copyright © 2021 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-cff31ddada976d23c759eed0fe165aaee6acf5db1f66048c90c292d75fc325e53</citedby><cites>FETCH-LOGICAL-c417t-cff31ddada976d23c759eed0fe165aaee6acf5db1f66048c90c292d75fc325e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33217367$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bui, Dinh S</creatorcontrib><creatorcontrib>Lodge, Caroline J</creatorcontrib><creatorcontrib>Perret, Jennifer L</creatorcontrib><creatorcontrib>Lowe, Adrian</creatorcontrib><creatorcontrib>Hamilton, Garun S</creatorcontrib><creatorcontrib>Thompson, Bruce</creatorcontrib><creatorcontrib>Giles, Graham</creatorcontrib><creatorcontrib>Tan, Daniel</creatorcontrib><creatorcontrib>Erbas, Bircan</creatorcontrib><creatorcontrib>Pirkis, Jane</creatorcontrib><creatorcontrib>Cicuttini, Flavia</creatorcontrib><creatorcontrib>Cassim, Raisa</creatorcontrib><creatorcontrib>Bowatte, Gayan</creatorcontrib><creatorcontrib>Thomas, Paul</creatorcontrib><creatorcontrib>Garcia-Aymerich, Judith</creatorcontrib><creatorcontrib>Hopper, John</creatorcontrib><creatorcontrib>Abramson, Michael J</creatorcontrib><creatorcontrib>Walters, Eugene H</creatorcontrib><creatorcontrib>Dharmage, Shyamali C</creatorcontrib><title>Trajectories of asthma and allergies from 7 years to 53 years and associations with lung function and extrapulmonary comorbidity profiles: a prospective cohort study</title><title>The lancet respiratory medicine</title><addtitle>Lancet Respir Med</addtitle><description>Longitudinal trajectories of asthma and allergies from childhood to adulthood might be differentially associated with lung function and chronic obstructive pulmonary disease (COPD), but associations with extrapulmonary comorbidities have not been well investigated. We aimed to assess these trajectories and examine their associations with lung function outcomes and profiles of comorbidities.
In this prospective cohort study, data for asthma and related allergic conditions (ie, eczema, hay fever, and food allergy) were prospectively collected from the Tasmanian Longitudinal Health Study for participants aged 7–53 years originally recruited in Tasmania, Australia. All surviving individuals in the database with contact details were invited in the most recent follow-up (mean age 53 years). There were no exclusion criteria. With use of latent class analysis, we identified longitudinal trajectories of asthma and allergic conditions from 7–53 years, and profiles of self-reported extrapulmonary conditions recorded at 53 years. The associations between asthma and allergy trajectories and morbidity profiles and lung function at 53 years were investigated with regression models.
Between Sept 3, 2012, and Nov 8, 2016, of 6128 individuals invited, 3609 (58·9%) individuals were enrolled. We identified five asthma and allergy trajectories: minimal and least asthma and allergies (n= 1767 [49·0%]); late-onset hay fever, no asthma (n=1065 [29·5%]); early-onset remitted asthma and allergies (n=236 [6·5%]); late-onset asthma and allergies (n=317 [8·8%]); and early-onset persistent asthma and allergies (n=224 [6·2%]); and four profiles of extrapulmonary morbidities: minimal or least disease (n=2206 [61·1%]); dominant mental health disorders (n=861 [23·9%]); dominant cardiovascular diseases or risks (n=424 [11·7%]); and multiple disorders (n=117 [3·2%]). The late-onset asthma and allergies trajectory was predominantly associated with the multiple disorders profile (relative risk ratio 3·3 [95% CI 1·9–5·9]), whereas the other asthma and allergy trajectories were associated only with the dominant mental health disorders profile. Both spirometrically defined and clinical COPD were most strongly associated with the early-onset persistent asthma and allergies trajectory (odds ratio [OR] 5·3 [95% CI 3·2–8·6]) and also with the late-onset asthma and allergies trajectory (OR 3·8 [2·4–6·1]).
Distinct longitudinal trajectories of asthma and allergic disease from childhood to 53 years are associated with different profiles of extrapulmonary comorbidities and varying risk of COPD. These findings can inform a personalised approach in clinical guidelines and management focusing on treatable traits. Comorbidity profiles are a new target for early identification and intervention.
National Health and Medical Research Council of Australia, EU's Horizon 2020, The University of Melbourne, Clifford Craig Medical Research Trust of Tasmania, The Victorian, Queensland & Tasmanian Asthma Foundations, The Royal Hobart Hospital, Helen MacPherson Smith Trust, and GlaxoSmithKline.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age of Onset</subject><subject>Asthma - diagnosis</subject><subject>Asthma - epidemiology</subject><subject>Child</subject><subject>Comorbidity</subject><subject>Female</subject><subject>Humans</subject><subject>Hypersensitivity - diagnosis</subject><subject>Hypersensitivity - epidemiology</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnosis</subject><subject>Pulmonary Disease, Chronic Obstructive - epidemiology</subject><subject>Self Report - statistics & numerical data</subject><subject>Severity of Illness Index</subject><subject>Spirometry - statistics & numerical data</subject><subject>Tasmania - epidemiology</subject><subject>Young Adult</subject><issn>2213-2600</issn><issn>2213-2619</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUctOHDEQtFAiQAufQOQjOSzxY8azk0sUIV4SEofA2eq126zRzHhje0j2g_KfeHY3XPHF5VK1u7qLkDPOLjjj6tsvIbicC8XYuWBfJavKSx2Q4z3N20_vmLEjcprSCytnsagEqw7JkZSCN1I1x-TfY4QXNDlEj4kGRyHlVQ8UBkuh6zA-T7yLoacN3SDERHOgtdzjrSylYDxkH4ZE__i8ot04PFM3Dmbithr8myOsx64PA8QNNaEPcemtzxu6jsH5DtN3ChNO6-LGv2LRrELMNOXRbk7IZwddwtP9PSNP11ePl7fz-4ebu8uf93NT8SbPjXOSWwsW2kZZIU1Tt4iWOeSqBkBUYFxtl9wpxaqFaZkRrbBN7YwUNdZyRs53_xYjv0dMWfc-Gew6GDCMSYtKSc4WbVnejNQ7qSmeU0Sn19H3ZTjNmZ5C0tuQ9JSAFkxvQ9Kq1H3ZtxiXPdr3qv-RFMGPnQDLoK8eo07G42DQ-lhWo23wH7R4A-Jupbs</recordid><startdate>20210401</startdate><enddate>20210401</enddate><creator>Bui, Dinh S</creator><creator>Lodge, Caroline J</creator><creator>Perret, Jennifer L</creator><creator>Lowe, Adrian</creator><creator>Hamilton, Garun S</creator><creator>Thompson, Bruce</creator><creator>Giles, Graham</creator><creator>Tan, Daniel</creator><creator>Erbas, Bircan</creator><creator>Pirkis, Jane</creator><creator>Cicuttini, Flavia</creator><creator>Cassim, Raisa</creator><creator>Bowatte, Gayan</creator><creator>Thomas, Paul</creator><creator>Garcia-Aymerich, Judith</creator><creator>Hopper, John</creator><creator>Abramson, Michael J</creator><creator>Walters, Eugene H</creator><creator>Dharmage, Shyamali C</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210401</creationdate><title>Trajectories of asthma and allergies from 7 years to 53 years and associations with lung function and extrapulmonary comorbidity profiles: a prospective cohort study</title><author>Bui, Dinh S ; Lodge, Caroline J ; Perret, Jennifer L ; Lowe, Adrian ; Hamilton, Garun S ; Thompson, Bruce ; Giles, Graham ; Tan, Daniel ; Erbas, Bircan ; Pirkis, Jane ; Cicuttini, Flavia ; Cassim, Raisa ; Bowatte, Gayan ; Thomas, Paul ; Garcia-Aymerich, Judith ; Hopper, John ; Abramson, Michael J ; Walters, Eugene H ; Dharmage, Shyamali C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-cff31ddada976d23c759eed0fe165aaee6acf5db1f66048c90c292d75fc325e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age of Onset</topic><topic>Asthma - diagnosis</topic><topic>Asthma - epidemiology</topic><topic>Child</topic><topic>Comorbidity</topic><topic>Female</topic><topic>Humans</topic><topic>Hypersensitivity - diagnosis</topic><topic>Hypersensitivity - epidemiology</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Pulmonary Disease, Chronic Obstructive - diagnosis</topic><topic>Pulmonary Disease, Chronic Obstructive - epidemiology</topic><topic>Self Report - statistics & numerical data</topic><topic>Severity of Illness Index</topic><topic>Spirometry - statistics & numerical data</topic><topic>Tasmania - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bui, Dinh S</creatorcontrib><creatorcontrib>Lodge, Caroline J</creatorcontrib><creatorcontrib>Perret, Jennifer L</creatorcontrib><creatorcontrib>Lowe, Adrian</creatorcontrib><creatorcontrib>Hamilton, Garun S</creatorcontrib><creatorcontrib>Thompson, Bruce</creatorcontrib><creatorcontrib>Giles, Graham</creatorcontrib><creatorcontrib>Tan, Daniel</creatorcontrib><creatorcontrib>Erbas, Bircan</creatorcontrib><creatorcontrib>Pirkis, Jane</creatorcontrib><creatorcontrib>Cicuttini, Flavia</creatorcontrib><creatorcontrib>Cassim, Raisa</creatorcontrib><creatorcontrib>Bowatte, Gayan</creatorcontrib><creatorcontrib>Thomas, Paul</creatorcontrib><creatorcontrib>Garcia-Aymerich, Judith</creatorcontrib><creatorcontrib>Hopper, John</creatorcontrib><creatorcontrib>Abramson, Michael J</creatorcontrib><creatorcontrib>Walters, Eugene H</creatorcontrib><creatorcontrib>Dharmage, Shyamali C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The lancet respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bui, Dinh S</au><au>Lodge, Caroline J</au><au>Perret, Jennifer L</au><au>Lowe, Adrian</au><au>Hamilton, Garun S</au><au>Thompson, Bruce</au><au>Giles, Graham</au><au>Tan, Daniel</au><au>Erbas, Bircan</au><au>Pirkis, Jane</au><au>Cicuttini, Flavia</au><au>Cassim, Raisa</au><au>Bowatte, Gayan</au><au>Thomas, Paul</au><au>Garcia-Aymerich, Judith</au><au>Hopper, John</au><au>Abramson, Michael J</au><au>Walters, Eugene H</au><au>Dharmage, Shyamali C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trajectories of asthma and allergies from 7 years to 53 years and associations with lung function and extrapulmonary comorbidity profiles: a prospective cohort study</atitle><jtitle>The lancet respiratory medicine</jtitle><addtitle>Lancet Respir Med</addtitle><date>2021-04-01</date><risdate>2021</risdate><volume>9</volume><issue>4</issue><spage>387</spage><epage>396</epage><pages>387-396</pages><issn>2213-2600</issn><eissn>2213-2619</eissn><abstract>Longitudinal trajectories of asthma and allergies from childhood to adulthood might be differentially associated with lung function and chronic obstructive pulmonary disease (COPD), but associations with extrapulmonary comorbidities have not been well investigated. We aimed to assess these trajectories and examine their associations with lung function outcomes and profiles of comorbidities.
In this prospective cohort study, data for asthma and related allergic conditions (ie, eczema, hay fever, and food allergy) were prospectively collected from the Tasmanian Longitudinal Health Study for participants aged 7–53 years originally recruited in Tasmania, Australia. All surviving individuals in the database with contact details were invited in the most recent follow-up (mean age 53 years). There were no exclusion criteria. With use of latent class analysis, we identified longitudinal trajectories of asthma and allergic conditions from 7–53 years, and profiles of self-reported extrapulmonary conditions recorded at 53 years. The associations between asthma and allergy trajectories and morbidity profiles and lung function at 53 years were investigated with regression models.
Between Sept 3, 2012, and Nov 8, 2016, of 6128 individuals invited, 3609 (58·9%) individuals were enrolled. We identified five asthma and allergy trajectories: minimal and least asthma and allergies (n= 1767 [49·0%]); late-onset hay fever, no asthma (n=1065 [29·5%]); early-onset remitted asthma and allergies (n=236 [6·5%]); late-onset asthma and allergies (n=317 [8·8%]); and early-onset persistent asthma and allergies (n=224 [6·2%]); and four profiles of extrapulmonary morbidities: minimal or least disease (n=2206 [61·1%]); dominant mental health disorders (n=861 [23·9%]); dominant cardiovascular diseases or risks (n=424 [11·7%]); and multiple disorders (n=117 [3·2%]). The late-onset asthma and allergies trajectory was predominantly associated with the multiple disorders profile (relative risk ratio 3·3 [95% CI 1·9–5·9]), whereas the other asthma and allergy trajectories were associated only with the dominant mental health disorders profile. Both spirometrically defined and clinical COPD were most strongly associated with the early-onset persistent asthma and allergies trajectory (odds ratio [OR] 5·3 [95% CI 3·2–8·6]) and also with the late-onset asthma and allergies trajectory (OR 3·8 [2·4–6·1]).
Distinct longitudinal trajectories of asthma and allergic disease from childhood to 53 years are associated with different profiles of extrapulmonary comorbidities and varying risk of COPD. These findings can inform a personalised approach in clinical guidelines and management focusing on treatable traits. Comorbidity profiles are a new target for early identification and intervention.
National Health and Medical Research Council of Australia, EU's Horizon 2020, The University of Melbourne, Clifford Craig Medical Research Trust of Tasmania, The Victorian, Queensland & Tasmanian Asthma Foundations, The Royal Hobart Hospital, Helen MacPherson Smith Trust, and GlaxoSmithKline.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33217367</pmid><doi>10.1016/S2213-2600(20)30413-6</doi><tpages>10</tpages></addata></record> |
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| ispartof | The lancet respiratory medicine, 2021-04, Vol.9 (4), p.387-396 |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adolescent Adult Age of Onset Asthma - diagnosis Asthma - epidemiology Child Comorbidity Female Humans Hypersensitivity - diagnosis Hypersensitivity - epidemiology Longitudinal Studies Male Middle Aged Prospective Studies Pulmonary Disease, Chronic Obstructive - diagnosis Pulmonary Disease, Chronic Obstructive - epidemiology Self Report - statistics & numerical data Severity of Illness Index Spirometry - statistics & numerical data Tasmania - epidemiology Young Adult |
| title | Trajectories of asthma and allergies from 7 years to 53 years and associations with lung function and extrapulmonary comorbidity profiles: a prospective cohort study |
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