Bronchial hyperresponsiveness in an adult population in Helsinki: decreased FEV1, the main determinant. (21st March 2013)

• Record Type: Journal Article
• Authors: Juusela, Maria; Pallasaho, Paula; Sarna, Seppo; Piirilä, Päivi; Lundbäck, Bo; Sovijärvi, Anssi
• Is Part Of: Clinical respiratory journal. Volume 7:Number 1(2013)
• Page Start: 34
• Page End: 44
• Publication Date: 2013-03-21
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 616.24
• DOI: 10.1111/j.1752-699X.2012.00279.x
• Languages: English
• ISSNs: 1752-6981

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <p> <bold>Introduction: </bold> Bronchial hyperresponsiveness (BHR) elevates the risk for development of respiratory symptoms and accelerates the decline in forced expiratory volume in the first second (FEV<sub>1</sub>). We thus aimed to assess the prevalence, determinants and quantity of BHR in Helsinki.</p> <p> <bold>Objectives: </bold> This study involved 292 randomly selected subjects age 26–66 years, women comprising 58%.</p> <p> <bold>Methods: </bold> Following a structured interview, a spirometry, a bronchodilation test, and a skin‐prick test, we assessed a bronchial challenge test with inhaled histamine using a dosimetric tidal breathing method. Results included the provocative dose inducing a decrease in FEV<sub>1</sub> by 15% (PD<sub>15</sub>FEV<sub>1</sub>) and the dose‐response slope. For statistical risk factor‐analyses, the severity of BHR was considered; PD<sub>15</sub> values ≤1.6 mg (BHR) and ≤0.4 mg [moderate or severe BHR (BHR<sub>ms</sub>)] served as cut‐off levels.</p> <p> <bold>Results: </bold> BHR presented in 21.2% and BHR<sub>ms</sub> in 6.2% of the subjects. FEV<sub>1</sub> < 80% of predicted [odds ratio (OR) 4.09], airway obstruction (FEV<sub>1</sub>/forced vital capacity < 88% of predicted) (OR 4.33) and history of respiratory infection at age <5 (OR 2.65) yielded an increased risk for BHR as ORs in multivariate analysis. For BHR<sub>ms</sub>, the determinants were decreased FEV<sub>1</sub> below 80% of predicted (OR 27.18) and airway obstruction (OR 6.16). Respiratory symptoms and asthma medication showed a significant association with BHR.</p> <p> <bold>Conclusions: </bold> Of the adult population of Helsinki, 21% showed BHR to inhaled histamine. The main determinants were decreased FEV<sub>1</sub> and airway obstruction. Quantitative assessment of BHR by different cut‐off levels provides a tool for characterization of phenotypes of airway disorders in epidemiologic and clinical studies.</p> <p>Please cite this paper as: Juusela M, Pallasaho P, Sarna S, Piirilä P, Lundbäck B and Sovijärvi A. Bronchial hyperresponsiveness in an adult population in Helsinki: decreased FEV<sub>1</sub>, the main determinant. <italic>Clin Respir J</italic> 2013; 7: 34–44.</p> </abstract>