Identifying critical time windows for lung function change from childhood to adulthood

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Background: We previously described the existence of lung function catch-up and growth failure in children. However, it is not clear if this may occur in adolescence and early adulthood. Aim: To explore individual lung function trajectories from childhood to adulthood using FEV1 and FEV1/FVC measurements jointly. Methods: We included 2010 participants from the BAMSE cohort with two or more pre-bronchodilator lung function measurementsmeasurements at ages 8, 16, and/or 24 years. An unbiased, data-driven dependent mixture model was applied to explore lung function trajectories. Participants were assigned to the “persistent” or “moving” groups if their trajectories remained stable or changed, respectively, across follow-ups. The “moving” group include both catch-up and growth failure. Results were validated in the PIAMA (8 to 16y, n= 909) and Lifelines (18 to 35y, n=2909) cohorts. Results: In BAMSE, seven “persistent” lung function trajectories were identified: very high, high, normal, dysanaptic obstructive, low, very low, and small lung trajectories. Similar “persistent” trajectories were observed in PIAMA and Lifelines. In BAMSE, 12.9% of participants moved between trajectories between ages 8 and 16 years, whereas only 4.8% did between 16 and 24 years. In PIAMA, 14.2% of participants moved between trajectories from 8 to 12 years, and 6.6% between 12 and 16 years. In Lifelines, only 0.7% of participants shifted between lung function trajectories from 18 to 35 years. Conclusions: Lung function changes between different trajectories were more frequently during childhood than adolescence and early adulthood. These findings should be considered in relation to interventions promoting lung health.

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