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Wheeze Phenotypes and Lung Function in Pre-School Children.
Lowe L, Simpson A, Woodcock AA, Morris J, Murray CS, Custovic A
Am J Respir Crit Care Med. 2005;171(3).
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Abstract
Distinct phenotypes can be identified in childhood wheezing illness.Within the context of a birth cohort study, we investigated theassociation between pre-school lung function and phenotypes of wheeze.Based on parentally-reported history of wheeze (interviewer-administeredquestionnaire, age 3 and 5 years), children were classified as neverwheezers, transient early wheezers, late-onset wheezers or persistentwheezers. Lung function (specific airway resistance-sRaw;kiloPascal/second) was assessed at age 3 (n=463) and 5 years (n=690).Persistent wheezers had markedly poorer lung function compared to othergroups. In children who had wheezed by age 3 years, the risk of persistentwheeze increased with increased sRaw (odds ratio, 95% confidenceintervals: 5.2, 1.3-22.0, p=0.02). In a multivariate model, increasingsRaw (5.5, 1.2-25.9, p=0.03) and child's sensitisation (2.8, 1.3-5.8,p=0.008) were significant independent predictors of persistent wheezing.We found no association between lung function at age three and late-onsetwheeze in children who had not wheezed previously (0.6, 0.07-5.3, p=0.64).In conclusion, poor lung function at age 3 years predicted the subsequentpersistence of symptoms in children who had wheezed within the first 3years, but was not associated with the onset of wheeze after age 3 yearsin children who had not wheezed previously.