Asthma and lung structure on computed tomography: The Multi-Ethnic Study of Atherosclerosis Lung Study

Kathleen M. Donohue, Eric A. Hoffman, Heather Baumhauer, Junfeng Guo, Firas S. Ahmed, Gina S. Lovasi, David R. Jacobs, Paul Enright, R. Graham Barr

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background: The potential consequences of asthma in childhood and young adulthood on lung structure in older adults have not been studied in a large, population-based cohort. Objective: The authors hypothesized that a history of asthma onset in childhood (age 18 years or before) or young adulthood (age 19-45 years) was associated with altered lung structure on computed tomography in later life. Methods: The Multi-Ethnic Study of Atherosclerosis Lung Study recruited 3965 participants and assessed asthma history by using standardized questionnaires, guideline-based spirometry, and segmental airway dimensions and percentage of low attenuation area (%LAA) on computed tomographic scans. Results: Asthma with onset in childhood and young adulthood was associated with large decrements in FEV1 among participants with a mean age of 66 years (-365 mL and -343 mL, respectively; P < .001). Asthma with onset in childhood and young adulthood was associated with increased mean airway wall thickness standardized to an internal perimeter of 10 mm (0.1 mm, P < .001 for both), predominantly from narrower segmental airway lumens (-0.39 mm and -0.34 mm, respectively; P < .001). Asthma with onset in childhood and young adulthood also was associated with a greater %LAA (1.69% and 4.30%, respectively; P < .001). Findings were similar among never smokers, except that differential %LAA in childhood-onset asthma were not seen in them. Conclusion: Asthma with onset in childhood or young adulthood was associated with reduced lung function, narrower airways, and among asthmatic patients who smoked, greater %LAA in later life.

Original languageEnglish (US)
Pages (from-to)361-368.e11
JournalJournal of Allergy and Clinical Immunology
Volume131
Issue number2
DOIs
StatePublished - Feb 2013

Keywords

  • Airway remodeling
  • airway structure
  • asthma
  • emphysema
  • epidemiology

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