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R Van der Lende

Publications and source records attributed to R Van der Lende.

6 recordsLinked to original sources
PubMed1993

Factors associated with bronchial responsiveness to histamine in a population sample of adults.

The association of age, gender, number of eosinophils, area of residence, cigarette smoking, respiratory symptom prevalence, and FEV1 with the level of bronchial responsiveness was studied in a random sample of 2,216 subjects aged 15 to 72 yr. Subjects participated in the Dutch longitudinal study on chronic obstructive pulmonary disease. In 18 yr of follow-up, 5,012 observations were collected. Interviewers used a standardized questionnaire to assess the presence of respiratory symptoms. Bronchial responsiveness was measured by a histamine challenge test. Because multiple measurements within a subject are correlated, multivariate regression methods for correlated outcome were used. A greater number of eosinophils, skin test positivity, and living in a rural area (Vlagtwedde) were associated with increased responsiveness, independently of the level of FEV1 and the presence of respiratory symptoms. Older age was associated with increased responsiveness, and this was even more so in subjects with symptoms. Cigarette smokers were more responsive than nonsmokers, but this association was not significant if the level of FEV1 was taken into account. Hyperresponsiveness was more likely to be present if the amount of cigarettes smoked per day was greater. The level of responsiveness did not differ significantly between males and females. For the same degree of obstruction, however, expressed as the FEV1/VC ratio, males tended to be less responsive than females. The analyses were repeated using the dose-response slope as a continuous measure of responsiveness and by applying a method to adjust for censoring the responsiveness data. These analyses yielded identical results.

Adult↗
PubMed1993

Long-term variability of bronchial responsiveness to histamine in a random population sample of adults.

Long-term variability of bronchial responsiveness has been studied in a random population sample of adults. During a follow-up period of 18 yr, 2,216 subjects contributed 5,012 observations to the analyses. Each subject could have as many as seven observations. Bronchial responsiveness was assessed with a histamine challenge test. The threshold value was defined as the concentration of histamine that caused a decrease in FEV1 of 10% of more (PC10). After a 3-yr interval, a change of the threshold value with two or more doubling concentrations occurred in 21% of the subjects. This proportion increased to 43% if the time between two measurements increased to 18 yr. Of all subjects with multiple observations, 41% were always nonresponders (PC10 > or = 32 mg/ml), 11% were always responders (PC10 < or = 16 mg/ml), and 48% changed responder status. Of the subjects with greater than three observations, 65% changed responder status. Regression analyses, stratified by symptom status, sex, and smoking habit, were used to estimate intraclass correlation coefficients (ICC) as a measure of variability of responsiveness. On average, ICC values were low (0.40), also indicating considerable variability. With adjustment for FEV1, age, area of residence, and eosinophil count, the ICC values decreased slightly. This indicated that with adjustment, the total variability decreased more than the within-subject variability. ICC values did not differ significantly between asymptomatic and symptomatic subjects. Analyses of responsiveness as a binary variable revealed similar results.

Adolescent↗
PubMed1992

Relationship of skin test reactivity and eosinophilia to level of pulmonary function in a community-based population study.

We studied the relationship of skin test reactivity (sumscore greater than or equal to 3) and eosinophilia (greater than or equal to 275 cells/mm3 blood), separately and combined, to the level of FEV1 in a community cohort. We used the regression analysis technique, adjusting for age and area of residence, and stratifying by gender and cigarette smoking. Eosinophilia, among men, was associated with lower levels of FEV1 in skin test negative subjects with moderate cigarette smoking (greater than or equal to 10 pack-yr: beta = -250 ml, p = 0.02; greater than or equal to 10 pack-yr: beta = -234 ml, p less than 0.01) and in skin test positive subjects who either never smoked (beta = -228 ml, p = 0.06) or had only a brief history of smoking (beta = -428 ml, p less than 0.01). Eosinophilia, among women, was significantly associated with lower levels of FEV1 in never smokers (beta = -95 ml, p less than 0.01), especially if subjects were skin test positive as well (beta = -289 ml, p less than 0.01). Moderate cigarette smoking was uncommon in women. These data suggest an association of indices of inflammation (eosinophilia alone) and allergic inflammation (eosinophilia combined with skin test reactivity) with lower levels of FEV1, independent of the effect of cigarette smoking.

Age Factors↗
PubMed1988

Respiratory symptoms and the maximum expiratory flow-volume curve; a multivariate approach.

Information on the size and shape of about 8500 maximum expiratory flow-volume (MEFV) curves was related multivariately to respiratory symptoms to construct a sensitive measure of airflow limitation. The data were obtained in an epidemiological follow-up study of a normal population in The Netherlands. Using non-linear canonical correlation analysis, thirteen variables from each curve yielded two uncorrelated variates which were optimally related to two variates simultaneously derived from all respiratory data. Curves with different size and shape may yield the same probability for respiratory symptoms. In this context the scores of individuals on the scales of the two curve-derived variates do not have to be corrected for body or lung size. Using FEV1 and standing height about half as much of the variability in respiratory symptoms is explained as when using the whole MEFV-curve. Moreover, the distribution of the scores for the MEFV-curves allows the differentiation between three patterns of airflow limitation graphically. These three types suggest different pathophysiological mechanisms related to airways resistance and lung elastic recoil and may be used to characterize individual curves. One type relates to subjects with symptoms of 'asthma', one to airflow limitation as found among people with dyspnoea and elderly subjects and another to bronchitic symptoms. In females, the association of the MEFV-curve with 'asthma' is stronger than in males but much weaker with bronchitic symptoms. Curves found to be more related to 'asthma' or bronchitic symptoms, but not to dyspnoea, are more prevalent among current than among never smokers in males.

Adolescent↗
PubMed1986

Epidemiology of chronic obstructive pulmonary disease (COPD).

Epidemiology can contribute in the fight against COPD by: providing information necessary for planning and management of health care; contributing to the knowledge of natural history and etiology, which is important for treatment and prevention; providing information for early detection and for clinical decision making.

Adolescent↗