The effect of smoking on lung function: a clinical study of adult-onset asthma

Tommola, Minna; Ilmarinen, Pinja; Tuomisto, Leena E.; Haanpää, Jussi; Kankaanranta, Terhi; Niemelä, Onni; Kankaanranta, Hannu

doi:10.1183/13993003.00850-2016

Cited by 94 publications

(83 citation statements)

References 41 publications

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“…In our study FEV 1 declined 17.4 ml/year faster, and FVC declined 14.3 ml/year faster in the low activity group. Sex (male), high frequency of disease exacerbations, old age, absence of glucocorticoid treatment, and smoking have been found to accelerate FEV 1 decline in asthmatics [9,36,37]. After adjusting for these factors with multiple linear regression analysis, the association of physical activity with FEV 1 decline remained significant.…”

Section: Discussionmentioning

confidence: 99%

“…The patients were treated and monitored according to Finnish Asthma Program guidelines [19] either in the specialized care or in primary care. The collection of research data has been previously reported [7,9,10,20]. At diagnosis, data was collected on lung function, blood eosinophils, the initial pharmacotherapy, and asthma symptoms by Airways Questionnaire 20 (AQ20) [21].…”

Section: Methodsmentioning

confidence: 99%

“…time of asthma diagnosis), (2) the maximum lung function (Max 0-2.5 ) during the first 2.5 years after diagnosis (i.e. after start of anti-inflammatory therapy) based on the highest pre-bronchodilator FEV 1 % predicted, and (3) after 12 years of follow-up (Figure 2) [9].

10.1080/20018525.2018.1533753-F0002Figure 2.Representation of the three lung function measurement points. …”

Section: Methodsmentioning

confidence: 99%

“…In contrast, patients with disease onset at adulthood have often more severe asthma that rarely remits [7]. Recently, asthma diagnosed at adult-age has been shown to constitute a majority among all new cases of asthma [8], and it seems that several lifestyle factors such as cigarette smoking and obesity are major factors in adult-onset asthma [6,9]. Since the concept of adult-onset phenotypes is rather new, only few studies exist on it and there is no clear consensus on the best therapy for these patients.…”

Section: Introductionmentioning

confidence: 99%

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Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Loponen

Ilmarinen

Tuomisto

et al. 2018

European Clinical Respiratory Journal

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Background: There is a lack of knowledge on the association between daily physical activity and lung function in patients with asthma. Objective: This study aims to examine the association between daily physical activity and asthma control, lung function, and lung function decline in patients with adult-onset asthma. Design: This study is part of Seinäjoki Adult Asthma Study (SAAS), where 201 patients were followed for 12 years after asthma diagnosis. Daily physical activity was assessed at follow-up by a structured questionnaire and used to classify the population into subgroups of low (≤240 min) or high (>240 min) physical activity. Three spirometry evaluation points were used: 1. diagnosis, 2. the maximum lung function during the first 2.5 years after diagnosis (Max0-2.5), 3. follow-up at 12 years. Results: High physical activity group had slower annual FEV1 (p<0.001) and FVC (p<0.018) decline. Additionally, the high physical activity group had higher FEV1 values at follow-up, and higher FEV1/FVC ratios at follow-up and diagnosis. There was no difference in BMI, smoking, medication, or frequency of physical exercise between high and low physical activity groups. Differences remained significant after adjustments for possible confounding factors. Conclusion: This is the first demonstration of an association between long-term FEV1 decline and daily physical activity in clinical asthma. Low physical activity is independently associated with faster decline in lung function. Daily physical activity should be recommended in treatment guidelines in asthma.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

10.1080/20018525.2018.1533753-F0002Figure 2.Representation of the three lung function measurement points. …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Loponen

Ilmarinen

Tuomisto

et al. 2018

European Clinical Respiratory Journal

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“…Several lines of evidence demonstrate that active and passive smoking leads to greater severity of asthma and act as a triggers to exacerbate asthma [45,46]. It appears that the diminished antioxidant capacity along with the oxidant excess associated with tobacco smoke leads to bronchial hyperresponsiveness and worsening airways obstruction [47,48] Due to the accelerated loss of lung function, there is an increased risk of development of COPD in asthmatics who smoke (see ‘Co-morbidities’) [49]. However, it is also important to recognize that smoking per se does not preclude a diagnosis of asthma, and fixed airflow obstruction in severe asthma is not synonymous with COPD.…”

Section: Systematic Assessment Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma (‘difficult asthma’) should undergo systematic assessment, in order to differentiate between true severe asthma, and ‘difficult-to-treat’ patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.

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Relationships between lung function decline and skeletal muscle and fat mass changes: a longitudinal study in healthy individuals

Park

Lee

et al. 2021

J cachexia sarcopenia muscle

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BackgroundThe associations between long-term changes in body mass composition and decline in lung function in healthy adults are unknown. Methods Using a well-defined health check-up database, we first assessed individual longitudinal changes in muscle mass (MM) and fat mass (FM) measured via bioelectrical impedance analyses. Then we classified the enrolled individuals into five body composition groups according to their MM index (MMI) [MM (kg)/height (m) 2 ] or FM index (FMI) [FM (kg)/height (m) 2 ] change rate quartiles. Linear mixed models adjusted for age, smoking status, height, and body mass index were used to analyse the rate of forced expiratory volume in 1 s (FEV1) decline and body composition groups. Results A total of 15 476 middle-aged individuals (6088 women [mean age ± standard deviation: 50.74 ± 7.44] and 9388 men [mean age ± standard deviation: 49.36 ± 6.99]) were enrolled. The mean number of measurements was 6.96 (interquartile range [IQR]: 5-9) over an average follow-up period of 8.95 years (IQR: 6.73-11.10). Decrease in MMI was significantly associated with accelerated FEV1 decline in men only (P = 1.7 × 10 À9 ), while increase in FMI was significantly associated with accelerated FEV1 decline in both women and men (P = 7.9 × 10 À10 and P < 2.0 × 10 À16 respectively). Linear mixed model analyses indicated that annual increase of 0.1 kg/m 2 in MMI was related to accelerated FEV1 decline by 30.79 mL/year (95% confidence interval [CI]: 26.10 to 35.48 mL/year) in men. Annual increase of 0.1 kg/m 2 in FMI was related to accelerated FEV1 decline by 59.65 mL/year in men (95% CI: 56.84 to 62.28 mL/year) and by 22.84 mL/year in women (95% CI: 18.95 to 26.74 mL/year). In body composition analysis, we found increase in MMI was significantly associated with attenuated FEV1 decline in men only (P = 1.7 × 10 À9 ), while increase in FMI was significantly associated with accelerated FEV1 decline in both women and men (P = 7.9 × 10 À10 and P < 2.0 × 10 À16 respectively). Individuals characterized with gain MM combined with loss of FM were associated with the most favourable outcome (i.e. the smallest rate of decline in FEV1) in both women and men. In men, loss of FM over time is more closely related with attenuated FEV1 decline than change in MM (gain or loss). Conclusions Change in body composition over time can be used to identify healthy middle-aged individuals at high risk for rapid FEV1 decline.

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The effect of smoking on lung function: a clinical study of adult-onset asthma

Cited by 94 publications

References 41 publications

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Relationships between lung function decline and skeletal muscle and fat mass changes: a longitudinal study in healthy individuals

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