Markers of impaired growth of pulmonary function in children and adolescents

Our knowledge about the age-related growth of pulmonary function is incompl ete. The purpose of this study was to describe the relation of various fact ors to the growth of pulmonary function in children and adolescents. A popu lation sample comprising 408 children and adolescents (7-17 yr of age at en rollment) was reexamined after a 6-yr interval. Case history was obtained b y interview and questionnaire. Pulmonary function, skin prick test reactivi ty to common allergens, and airway responsiveness (AR) were measured using standard techniques; airway hyperresponsiveness (AHR) was defined as a conc entration of histamine causing a 20% decline in FEV1 < 8 mg/ml. The cross-s ectional analyses of data from the two surveys showed that the presence of asthma (p < 0.02), atopy to house dust mite (HDM) (p = 0.03), and increasin g degree of AR (p < 0.002) were associated with a lower level of FEV1 %pred . The longitudinal analysis revealed that asthma (p = 0.0001) and a lower l evel of FEV1 (p < 0.0001) at enrollment were associated with a lower level of FEV1 at follow-up. Further, an increase in the degree of AR (p = 0.0001) , new asthma (p = 0.0002), and new atopy to HDM (p = 0.03) also predicted a lower level of FEV1 at the end of the observation period. Confining the an alysis to subjects without asthma and without evidence of AHR (n = 271) sho wed that both persistent (p = 0.04) and new (p = 0.03) atopy to HDM predict ed a lower level of FEV1 at follow-up; compared with subjects with a negati ve skin reaction to HDM, those subjects who were sensitized to HDM had on a verage a 5%pred lower level of FEV1. The growth of FEV1 in children and ado lescents appears to be impaired not only by symptomatic asthma but also by an increase in the degree of AR and atopy to HDM; sensitization to HDM appe ars to have a negative impact on the age-related growth in FEV1 even in non asthmatic subjects without evidence of AHR.