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PubMedDate not supplied

Lung function in Indian twin children: comparison of genetic versus environmental influence.

The relative contributions of genetic and environmental components in the variability of lung function measurements were studied in 54 twin pairs. Thirty pairs of monozygote (MZ) twins and 24 pairs of dizygotic (DZ) twins were examined. All measurements were made with 9-litre closed-circuit-type expirographs using standard spirometric techniques, except for peak expiratory flow rate (PFER) which was recorded with a Wright peak flow meter. Within-pair variances for inspiratory capacity (IC), vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced mid-expiratory flow (FEV25-75%), forced end-expiratory flow (FEF75-85%), maximum expiratory flow (FEF200-1200ml), forced maximum voluntary ventilation MVVF) and PEFR were significantly smaller (p < 0.01) in MZ twins than in DZ twins. Tidal volume (VT), inspiratory reserve volume (IRV), expiratory reserve volume (ERV), forced expiratory volume in 1 second as a percentage of forced vital capacity (FEV1%), and forced expiratory time (FET) were not significantly different. Within-pair correlations were all higher in MZ than DZ twins. All measurements except for VT and PEFR showed high levels of heritability (23-99%). All measurements were positively and significantly correlated with physical characteristics such as weight, standing height, surface area, arm-span, chest circumference and age, except FEV1% and FET. Residual values adjusted for physical characteristics showed similar results to unadjusted values in most cases. These data indicate that major lung function measurements are possibly influenced more by genetic than environmental factors. Genetically influenced measurements show higher levels of heritability estimates and suggest that genetic determination of lung function is possibly independent of the influence of physical characteristics.

Adolescent↗

PubMed2001

Association between vitamin A status and lung function level in children aged 6--9 years in Wukro wereda, Northern Ethiopia.

BACKGROUND: In developing countries, studies using morbidity recalls to evaluate the benefits of vitamin A on respiratory health in children under 6 years of age have been inconclusive. This relationship has not been examined in older children. Spirometric measurements, an objective means of assessing respiratory health, require the subject's collaboration and have been successfully used in children over 6 years of age. This report describes a cross-sectional analysis of the relationship between lung function and vitamin A status in an area endemic to vitamin A deficiency. METHODS: The data on which this report is based were gathered prior to the implementation of a prospective trial of the effect of vitamin A supplementation on lung function level in Northern Ethiopia. Vitamin A status was assessed by the Modified Relative Dose Response (MRDR) method and lung function assessed by spirometry in 702 rural children aged 6--9 years. Demographic, personal health, household, environmental and socioeconomic data were gathered by questionnaire. RESULTS: In children with low vitamin A reserve, the unadjusted forced expiratory volume in one second (FEV(1)) was 48.8 ml (P = 0.006) lower than in those with adequate reserve. This difference was 23.1 ml (P = 0.04) when adjusted for age, gender and height and 14.1 ml (P = 0.20) when adjusted for children's demographic, general health, lung function and household-related characteristics. CONCLUSION: Although these findings suggest that vitamin A plays a relatively minor role in determining FEV(1) level, interpretation is limited by the cross-sectional design. Further clarification of its role requires a trial of vitamin A supplementation.

Anthropometry↗

PubMed1986

Effect of esophageal variceal sclerotherapy (EVS) on lung function. A prospective controlled study.

A prospective, controlled study to determine the short- and long-term effects of esophageal variceal sclerotherapy (EVS) on lung function was carried out on 11 patients with cirrhotic portal hypertension and variceal hemorrhage. Eleven patients with chronic liver disease undergoing diagnostic endoscopy served as controls. There was no difference in lung function tests and gas exchange in both the EVS or control groups after either procedure. No change in these parameters was noted during follow-up on continued sclerotherapy in the EVS group. Ventilation-perfusion scans and chest roentgenograms, performed before and after EVS, demonstrated no significant change. We conclude that in patients with stable liver disease and without hepatic failure, EVS does not result in serious short- and long-term impairment of lung function.

Adult↗

PubMed1995

Dietary antioxidant vitamin intake and lung function in the general population.

We have investigated the relation between lung function and dietary intake of the antioxidant vitamins C and E in the general population in a cross-sectional survey of a random sample of adults from the electoral register of an administrative area of Nottingham. In 2,633 subjects 18 to 70 yr of age, we measured FEV1 and FVC, allergen skin sensitivity to grass pollen, cat fur, and Dermatophagoides pteronyssinus, pack-years smoking exposure by personal recall, and usual dietary intake of vitamins C and E by semiquantitative food frequency questionnaire. After adjustment for the effects of age, sex, height, mean allergen skin wheal diameter, and pack-years smoking history, both FEV1 and FVC were significantly and independently related to mean daily intake of vitamin C, such that a standard deviation (40 mg/d) higher vitamin C intake was associated with a 25.0 (95% CI, 5.2 to 44.8; p = 0.01) ml higher FEV1 and a 23.3 (0.94 to 45.7, p = 0.04) ml higher FVC. There was also an association between vitamin E intake and lung function, such that a standard deviation (2.2 mg) higher intake of vitamin E was associated with a 20.1 (1.3 to 40.4, p = 0.04) ml higher FEV1 and a 23.1 (1.0 to 45, p = 0.04) ml higher FVC. However, vitamin C and vitamin E intakes were significantly correlated (r = 0.29, p < 0.001), and after allowing for the effects of vitamin C there was no additional independent effect of vitamin E on either FEV1 or FVC.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1996

Lung function in children and adolescents with occasional exposure to environmental tobacco smoke.

We investigated the effects of occasional exposure to environmental tobacco smoke (ETS) on lung function in children. A total of 317 healthy 12- to 15-yr-old nonsmoking children and adolescents, living in households in which none of the adults were active smokers, were selected for the present analysis. The urinary cotinine:creatinine ratio (CCR) was taken as the biologic indicator of exposure, and children were classified according to CCR quartiles. The ratio between FEV1 and FVC (FEV1/FVC) and both early (peak expiratory flow [PEF]) and midexpiratory flow rates (FEF25-75) were lower in children with higher CCR values. In percent terms, the decrease in adjusted lung function for children belonging to the second, third, and fourth quartiles in comparison with those in the first quartile was -1.37, -2.12, and -1.94 for FEV1/FVC (p for trend = 0.012); 0.98, -3.31, and -4.54 for PEF (p for trend = 0.024); and -0.05, -4.85, and -6.13 for FEF25-75 (p for trend = 0.022), respectively. The effects remained significant when possible confounding by father's education and urinary creatinine level had been taken into account, and when children whose parents' smoking status may have been misclassified were excluded. This study suggests an adverse effect on lung function from even low-level exposure to ETS among nonsmoking children living with reportedly nonsmoking parents.

Adolescent↗

PubMed1981

[Guidelines towards examination of the lung function in children (author's transl)].

Examination of the lung function in school children is complicated and necessitates a considerable amount of technical equipment. The general practitioner carrying out the examination should not forget that a detailed clinical examination and a good stethoscope can provide important information for the diagnosis, differential diagnosis and further therapy of the child. The range of so-called simple electronic spirometers with a print-out of data tempts practitioner to use them in the diagnostics of the functioning of the lung. There is, however, considerable danger that these instruments lead more often in wrong results. A simple bell spirograph with a recording unit together with a helium analysis instrument allows the doctor to make a complete spirogram which gives exact information. In addition, the doctor requires a special lung laboratory to which to transfer children for a period of supervision and larger. The doctor should be aware that an absence of clinical symptoms, proved in practice, does not necessarily mean that the lung is working normally. Indication of an extended examination of the lungs can be deduced from a blood gas analysis, which can, with some practice be determined in the office. A reduced pO2 or an increased pCO2 can indeed indicate a disorder even when the child appears on examination to be clinically healthy. Instruments new commonly in use for analyzing the blood gas with capillary blood can also be introduced into the office.

Body Height↗

PubMed1993

The relationship between low-level air pollution exposure and short-term changes in lung function in Dutch children.

Following air pollution episodes in the winters of 1985 and 1987, a series of studies was initiated to investigate short-term changes in health status in children in relationship to short-term changes in air pollution concentrations. Air pollution exposure was characterized by measurements of SO2, NO2, PM10, nitrate, sulfate, H+, and HONO. Panels of unselected children were studied in four winters (1987-1991). Lung function was measured repeatedly with spirometry in these children. In the winter of 1990/1991, a panel of children with chronic respiratory symptoms was studied as well, with repeated observations of Peak Expiratory Flow made at the home. The three winters of 87/88, 88/89 and 89/90 were very mild; no air pollution episodes with long range transport from the east occurred. In these three winters, lung function was measured on 86 different days. Altogether, over 800 children participated. H+ concentrations (expressed as H2SO4) were generally below 0.6 microgram/m3, with a maximum of only 3 micrograms/m3. Daily mean SO2 concentrations never exceded 100 micrograms/m3 in this period. Nevertheless, lung function in these unselected children was found to decrease with increasing levels of especially particulate matter air pollution. In the winter of 1990/1991, a minor air pollution episode occurred. Maximum SO2 and PM10 concentrations were 105 micrograms/m3 and 174 micrograms/m3 respectively. This episode was associated with decreased lung function in a group of about 112 unselected children. There was also a relationship with decreased daily PEF readings in a panel of 73 children with chronic respiratory symptoms.

Air Pollutants↗

PubMed2003

Small airway morphology and lung function in the transition from normality to chronic airway obstruction.

This study investigated the relationships between pathological changes in small airways (<6 mm perimeter) and lung function in 22 nonasthmatic subjects (20 smokers) undergoing lung resection for peripheral lesions. Preoperative pulmonary function tests revealed airway obstruction [ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) < 70%] in 12 subjects and normal lung function in 10. When all subjects were considered together, total airway wall thickness was significantly correlated with FEV1/FVC (r2 = 0.25), reactivity to methacholine (r2 = 0.26), and slope of linear regression of FVC against FEV1 values recorded during the methacholine challenge (r2 = 0.56). Loss of peribronchiolar alveolar attachments was significantly associated (r2 = 0.25) with a bronchoconstrictor effect of deep inhalation, as assessed from a maximal-to-partial expiratory flow ratio <1, but not with airway responses to methacholine. No significant correlation was found between airway smooth muscle thickness and lung function measurements. In conclusion, this study suggests that thickening of the airway wall is a major mechanism for airway closure, whereas loss of airway-to-lung interdependence may contribute to the bronchoconstrictor effect of deep inhalation in the transition from normal lung function to airway obstruction in nonasthmatic smokers.

Aged↗

PubMed2000

A long-term follow-up of lung function in survivors of paraquat poisoning.

1. Respiratory failure is a frequent cause of death in moderate to severe paraquat poisoning, and a transient fall in the gas transfer factor may be seen in mild poisoning. 2. The objectives of this study were to detect long-term changes in lung function in survivors of paraquat poisoning. 3. We analyzed 12 survivors retrospectively for age, sex, signs and symptoms, laboratory findings, chest X-ray findings, serum paraquat level, and lung function test. The first and the follow-up lung tests were performed at 3.7+/-1.4 weeks and 3.4+/-1.4 years, respectively. 4. Serum paraquat levels were assayed in all patients and 3/12 were above the Proudfoot's predictive line. Liver dysfunction (GOT > 50) and renal dysfunction (BUN > 30) were noted in 5/12 and 8/12, respectively. D(L)/V(A) was lower than the normal limit in the first study (3.9+/-0.6 L), but increased significantly and returned to the normal range in the follow-up study (4.5+/-0.6 L). %VC was within the normal range in either examination, but significantly decreased in the follow-up. %TLC was within the normal range in the first study (87+/-13%), but significantly decreased below the normal limit in the follow-up (81+/-13%). 5. These results indicate that survivors of paraquat poisoning may be left with a restrictive type of pulmonary dysfunction and suggest that a long-term follow-up of lung function may be necessary for survivors of paraquat poisoning.

Accidents↗

PubMed2004

Preservation of post-transplant lung function with aerosol cyclosporin.

Post-lung transplant use of aerosol cyclosporin (ACsA) is considered by examining the relationship between deposited aerosol dose and effect. In a sub-study of placebo controlled trials of ACsA as a rejection prophylaxis, 15 drug subjects received aerosol dose quantification tests to gage their ability to effectively deposit the nebulised drug in their transplanted lung(s). A total of seven placebo subjects received mock deposition tests. The deposited doses and mock doses were compared to changes in the forced expiratory volume in one second, at six time points during the 2-yr trial period (ACsA was started within 6 weeks post-transplant). Linear relationships were demonstrated between deposited dose and improvement in lung function in the drug subjects at all intervals. Mock dose data from placebo subjects did not demonstrate similar correlation. Based on these results, subjects were grouped by dose and compared. Subjects depositing > or = 5 mg of the drug in the periphery of their transplant(s) had improving pulmonary function on average. Low-dose and placebo subjects demonstrated declines, more A2-A4 rejection events in the latter portion of the trial, and more chronic rejection beyond the end of the trial. A dose-to-effect relationship is demonstrated for aerosol cyclosporin in terms of pulmonary function and biopsy proven rejection.

Administration, Inhalation↗

PubMed2004

beta2 adrenoceptor Arg16Gly polymorphism, airway responsiveness, lung function and asthma in infants and children.

BACKGROUND: We have previously reported a relationship between increased airway responsiveness (AR) in infancy and reduced childhood lung function. OBJECTIVE: The current study aimed to determine whether the Arg16Gly polymorphism of the beta2 adrenoceptor (beta2AR) gene was important to this relationship. METHODS: A cohort that initially numbered 253 individuals underwent assessments of AR and lung function aged 1 month, 6 and 11 years; genotyping for polymorphisms of the beta(2)AR was performed. RESULTS: At 1 month of age, the genotype homozygous Arg16 (n=24) was associated with a mean increase in log dose-response slope (AR) of 0.27 [95% confidence interval (CI) 0.07, 0.49] compared with the genotype homozygous Gly16 (n=58), P=0.01. At 11 years of age, the genotype homozygous Arg16 (n=35) was associated with a mean reduction in the percentage of forced expiratory volume in 1 s of 5.3% [95% CI 0.3, 10.2] compared with the genotype homozygous Gly16 (n=65), P=0.03. There was no association between the Arg16Gly polymorphism and atopy or diagnosed asthma. However, nine of 69 individuals with the genotype homozygous Gly16 were admitted to hospital with asthma compared with five out of 111 individuals with the remaining genotypes (P<0.05). CONCLUSION: The Arg16Gly polymorphism may be important to the association between increased AR in infancy and reduced lung function in childhood and may also be a determinant of asthma severity in children but not asthma per se.

Asthma↗

PubMed1976

Correlation between lung function and tracheobronchial collapse.

In 30 unselected male patients, bronchoscopic aspect and lung function parameters (notch in FEV1, FEV1/FIV1%, discrepancy between airways resistance and FEV1, club-shaped resistance curves) were correlated to determine the validity of lung function in the diagnosis of a central bronchial collapse. There were no strong correlations; only the club-shaped resistance curve and FEV1/FIV1% less than 60 were a little more often seen in the presence of central bronchial collapse. It is concluded from these results, and with regard to the known results from bronchial pressure measurements, that the functional parameters mentioned above are good indicators of a flaccid tracheobronchial system but not typical for a central bronchial collapse alone. Additional methods (bronchoscopy, bronchial pressure measurements) are needed to locate the major pressure drop and to select the adequate therapy (conservative in the case of pure peripheral or most mixed situations, chirurgical in special cases with pure central bronchial collapse). The reactions of a collapsible tracheobronchial system to bronchodilating drugs are described and their help in location of the major pressure drop is discussed.

Bronchial Diseases↗

PubMed2003

Improved lung function and body mass index associated with long-term use of Macrolide antibiotics.

BACKGROUND: A number of studies have suggested that the non-antimicrobial actions of macrolide antibiotics may be valuable in treating patients with cystic fibrosis. The use of long-term macrolide antibiotics for the management of CF patients colonised by Pseudomonas aeruginosa and progressive pulmonary disease was introduced into our clinic in 1997. A retrospective study was undertaken to assess of the impact of this therapy. METHODS: Twenty patients with progressive pulmonary disease (>10% fall in FEV(1) over 12 months despite optimising conventional therapy) were commenced on Azithromycin, 250 mg daily during a 21-month period. At the time of assessment they had remained on therapy for a mean of 0.9 years. Changes in lung function, weight, body mass index (BMI) and frequency of pulmonary exacerbations were assessed. A group of 20 patients with stable lung function and matched as far as possible for age and sex was identified for comparison. RESULTS: Pulmonary function increased significantly in the Azithromycin group with FEV1% predicted increasing from a mean of 50.2-59.1% (P=0.001) while FVC% predicted increase from 64.5 to 76.1% (P=0.002). There was small but non-significant fall in lung function in the comparison group. Body mass index increased by a mean of 1.1 in the Azithromycin group but remained unchanged in the comparison group. The number of pulmonary exacerbations requiring intravenous antibiotics declined by 48.3% in macrolide treated subjects compared to the pre-treatment period (P<0.025); frequency of exacerbations in the control group was unchanged. CONCLUSION: Long-term Azithromycin treatment in patients with progressive deterioration in lung function appears to have led to an improvement in pulmonary function, increased body mass index and decreased the frequency of pulmonary exacerbations requiring intravenous antibiotics.

Adolescent↗

PubMed1977

Smoking and intermediate alpha1-antitrypsin deficiency and lung function in middle-aged men.

Lung function was evaluated in a representative population sample of 50-year-0ld men living in one Swedish city. Twenty-four smoking and 15 non-smoking men heterozygous for alpha1-antitrypsin deficiency--that is, with the protease-inhibitor (Pi1 phenotype MZ--were carefully matched for weight and smoking habit with Pi M controls. The pulmonary function of non-smoking Pi MZ subjects did not differ from that of non-smoking Pi M controls. In contrast, smoking heterozygotes showed a significant loss of elastic recoil, enlarged residual volumes, and increased closing capacity but no signs of obstructive ventilatory impairment. Most smoking Pi MZ individuals reported mild exertional dyspnoea.

Homozygote↗

PubMed2004

Progression of asthma measured by lung function in the childhood asthma management program.

From the Childhood Asthma Management Program cohort, which was randomly assigned to receive budesonide, nedocromil, or placebo for 4-6 years, we determined the prevalence of and factors associated with at least 1% per year loss in postbronchodilator FEV(1)% predicted. Participants who had a significant reduction in postbronchodilator FEV(1)% predicted (SRP), comprised 25.7% of the cohort (n = 990). Using logistic regression, predictors of SRP at baseline were younger age (p = 0.0005), male sex (p < 0.0001), clinic (p = 0.02), and higher postbronchodilator FEV(1)% predicted (p = 0.02). Examination of the SRPs indicated that the effect of baseline lung function was such that the higher the lung function, the less steep the reduction in postbronchodilator FEV(1)% predicted (p < 0.0001). A similar proportion of SRPs was found in each treatment group. Among the SRPs, the rate of reduction in postbronchodilator FEV(1)% predicted was similar in all treatment groups. At a single site where biomarker assessment was performed, SRPs also had more prominent eosinophilic inflammation during the washout period. The course and mechanisms of lung function reduction or slow lung growth velocity in children with asthma must be defined.

Administration, Inhalation↗

PubMed1991

Relation of birth weight and childhood respiratory infection to adult lung function and death from chronic obstructive airways disease.

OBJECTIVE: To examine whether birth weight, infant weight, and childhood respiratory infection are associated with adult lung function and death from chronic obstructive airways disease. DESIGN: Follow up study of men born during 1911-30 whose birth weights, weights at 1 year, and childhood illnesses were recorded at the time by health visitors. SETTING: Hertfordshire, England. SUBJECTS: 5718 men born in the county during 1911-30 and a subgroup of 825 men born in the county during 1920-30 and still living there. MAIN OUTCOME MEASURES: Death from chronic obstructive airways disease, mean forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), and respiratory symptoms. RESULTS: 55 men died of chronic obstructive airways disease. Death rates fell with increasing birth weight and weight at 1 year. Mean FEV1 at age 59 to 70 years, adjusted for height and age, rose by 0.06 litre (95% confidence interval 0.02 to 0.09) with each pound (450 g) increase in birth weight, independently of smoking habit and social class. Bronchitis or pneumonia in infancy was associated with a 0.17 litre (0.02 to 0.32) reduction in adult FEV1 and with an increased odds ratio of wheezing and persistent sputum production in adult life independently of birth weight, smoking habit, and social class. Whooping cough in infancy was associated with a 0.22 litre (0.02 to 0.42) reduction in adult FEV1. CONCLUSIONS: Lower birth weight was associated with worse adult lung function. Intrauterine influences which retard fetal weight gain may irrecoverably constrain the growth of the airways. Bronchitis, pneumonia, or whooping cough in infancy further reduced adult lung function. They also retarded infant weight gain. Consistent with this, death from chronic obstructive airways disease in adult life was associated with lower birth weight and weight at 1 year. Promoting lung growth in fetuses and infants and reducing the incidence of lower respiratory tract infection in infancy may reduce the incidence of chronic obstructive airways disease in the next generation.

Adult↗

PubMed2006

[Effect of health education on the lung function and life quality in patients with stable chronic obstructive pulmonary diseases].

OBJECTIVE: To evaluate the effect of health education on the symptoms, lung function and life quality in patients with stable chronic obstructive pulmonary diseases (COPD). METHODS: Eighty-two patients were assigned into 2 groups randomly: The treatment group (n = 43) accepted health education for 6 months and the control group (n = 39) did not. Before and after the 6 months, we observed the number of smokers, Borg score, inhale treatment, times of acute episode, SGRQ score, lung function, and the therapeutic effect in the two groups. RESULTS: Six months later, the ratio of smokers in the treatment group was 13.95%, much lower than that in the control group (35.90%, P = 0.021); the Borg score of the treatment group decreased from 4.86 +/- 1.21 to 3.38 +/- 0.94 (P =0.000), but there was no difference in the control group; the ratios of accepted inhale treatment in the treatment group and the control group were 100% (43/43) and 20.51 % (8/39) respectively (P = 0.000), and the accuracy rates were 100% (43/43 ) in the treatment group and 12. 82% (5/39) in the control group (P =0. 000); the times of acute episode in the treatment group was 1.51 +/- 1.53, much lower than that in the control group (4.46 +/- 5.17, P = 0. 000); the indexes of lung function before and after the 6 months between the two groups had no significant difference. The total score, the symptom section score, the activity section score, and the impact section score of SGRQ after the 6 months of health education were much lower than those of 6 months before, and those in the control group had no significant difference. CONCLUSION: Six months of the health education can decrease the ratio of smokers and the times of acute episode, and to improve the life quality of patients with stable COPD.

Adult↗

PubMed2006

Lung function decline and outcomes in an elderly population.

OBJECTIVE: To determine the risk factors for and outcomes associated with the rapid decline in lung function in a cohort of elderly US adults. METHODS: Data from 4923 adult participants aged 65 years and older at baseline in the Cardiovascular Health Study were analysed. Subjects were classified using a modification of the GOLD criteria for chronic obstructive pulmonary disease (COPD) and a "restricted" category (FEV1/FVC>or=70% and FVC<80% predicted) was added. Cox proportional hazard models were used to determine the risk of lung function decline over 4 years on subsequent mortality and COPD hospital admissions after adjusting for age, race, sex, smoking status, and other factors. RESULTS: Of the participants in the initial cohort, 3388 (68.8%) had spirometric tests at the year 4 visit. Participants with GOLD stages 3 or 4 COPD at baseline were less likely than normal subjects to have follow up spirometric tests (52.7% v 77.9%, p<0.01) and were more likely to be in the most rapidly declining quartile of FEV1 (28.2% v 21.3%, p<0.01) with an annual loss of FEV1 of at least 3.5%. Overall, being in the most rapidly declining quartile of FEV1 from baseline to year 4 was associated with an increased risk of admission to hospital for COPD (adjusted hazard ratio (HR) 1.6, 95% confidence interval (CI) 1.3 to 2.0) and all-cause death (adjusted HR 1.5, 95% CI 1.2 to 1.7) over an additional 7 years of follow up. CONCLUSION: More rapid decline in lung function is independently associated with a modest increased risk of hospital admissions and deaths from COPD in an elderly cohort of US participants.

Aged↗