Recurrent wheeze and its relationship with lung function and airway inflammation in preschool children: A cross-sectional study in South Korea

Ji Eun Soh, Kyung Moon Kim, Ji Won Kwon, Hyung Young Kim, Ju Hee Seo, Hyo Bin Kim, So Yeon Lee, Gwang Cheon Jang, Dae-Jin Song, Woo Kyung Kim, Young Ho Jung, Soo Jong Hong, Jung Yeon Shim

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4 Citations (Scopus)

Abstract

Background Relationship between recurrent wheeze and airway function and inflammation in preschool children is not fully known. Objective To investigate the relationship between recurrent wheeze and airway inflammation, lung function, airway hyper-reactivity (AHR) and atopy in preschool children. Design Observational study, comparing forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC) and mid-forced expiratory flow (FEF 25%-75%), dose-response slope (DRS), exhaled nitric oxide (eNO) and atopic sensitisation between children with recurrent wheeze and those without. Setting Population-based, cross-sectional study in Seoul and the Gyeonggi province of Korea conducted as a government-funded programme to perform standardised measurement of the prevalence of allergic diseases, and related factors, in preschool children. Participants 900 children aged 4-6 years. Primary and secondary outcome measures eNO, FEV 1 /FVC, FEF 25%-75%, DRS, atopic sensitisation and allergic diseases. Methods Children completed the modified International Study of Asthma and Allergies in Childhood questionnaire and underwent eNO assessments, spirometry, methacholine bronchial provocation tests and skin prick tests. Recurrent wheeze was defined as having a lifetime wheeze of more than three episodes, based on the questionnaire. The frequency of hospitalisation and emergency room visits was also obtained by means of the questionnaire. Current' wheeze was defined as having symptoms or treatments within the past 12 months. Results The prevalence of recurrent wheeze was 13.4%. Children with recurrent wheeze showed a higher prevalence of lifetime or current allergic rhinitis (p=0.01 and p=0.002, respectively) and lifetime atopic dermatitis (p=0.007). Children with recurrent wheeze showed lower FEV 1 /FVC (p=0.033) and FEF 25%-75% (p=0.004), and higher eNO levels (p=0.013) than those without recurrent wheeze. However, the DRS, prevalence of atopic sensitisation and serum IgE levels were not significantly different between the two groups. Conclusions Recurrent wheeze in preschool children may be associated with airway inflammation and diminished airway function, but not with AHR or atopy.

Original languageEnglish
Article numbere018010
JournalBMJ Open
Volume7
Issue number10
DOIs
Publication statusPublished - 2017 Oct 1

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Republic of Korea
Preschool Children
Cross-Sectional Studies
Inflammation
Vital Capacity
Forced Expiratory Volume
Nitric Oxide
Lung
Government Programs
Bronchial Provocation Tests
Methacholine Chloride
Spirometry
Atopic Dermatitis
Korea
Skin Tests
Immunoglobulin E
Observational Studies
Hospital Emergency Service
Pneumonia
Hypersensitivity

Keywords

  • asthma
  • epidemiology
  • paediatric thoracic medicine
  • respiratory physiology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Recurrent wheeze and its relationship with lung function and airway inflammation in preschool children : A cross-sectional study in South Korea. / Soh, Ji Eun; Kim, Kyung Moon; Kwon, Ji Won; Kim, Hyung Young; Seo, Ju Hee; Kim, Hyo Bin; Lee, So Yeon; Jang, Gwang Cheon; Song, Dae-Jin; Kim, Woo Kyung; Jung, Young Ho; Hong, Soo Jong; Shim, Jung Yeon.

In: BMJ Open, Vol. 7, No. 10, e018010, 01.10.2017.

Research output: Contribution to journalArticle

Soh, JE, Kim, KM, Kwon, JW, Kim, HY, Seo, JH, Kim, HB, Lee, SY, Jang, GC, Song, D-J, Kim, WK, Jung, YH, Hong, SJ & Shim, JY 2017, 'Recurrent wheeze and its relationship with lung function and airway inflammation in preschool children: A cross-sectional study in South Korea', BMJ Open, vol. 7, no. 10, e018010. https://doi.org/10.1136/bmjopen-2017-018010
Soh, Ji Eun ; Kim, Kyung Moon ; Kwon, Ji Won ; Kim, Hyung Young ; Seo, Ju Hee ; Kim, Hyo Bin ; Lee, So Yeon ; Jang, Gwang Cheon ; Song, Dae-Jin ; Kim, Woo Kyung ; Jung, Young Ho ; Hong, Soo Jong ; Shim, Jung Yeon. / Recurrent wheeze and its relationship with lung function and airway inflammation in preschool children : A cross-sectional study in South Korea. In: BMJ Open. 2017 ; Vol. 7, No. 10.
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abstract = "Background Relationship between recurrent wheeze and airway function and inflammation in preschool children is not fully known. Objective To investigate the relationship between recurrent wheeze and airway inflammation, lung function, airway hyper-reactivity (AHR) and atopy in preschool children. Design Observational study, comparing forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC) and mid-forced expiratory flow (FEF 25{\%}-75{\%}), dose-response slope (DRS), exhaled nitric oxide (eNO) and atopic sensitisation between children with recurrent wheeze and those without. Setting Population-based, cross-sectional study in Seoul and the Gyeonggi province of Korea conducted as a government-funded programme to perform standardised measurement of the prevalence of allergic diseases, and related factors, in preschool children. Participants 900 children aged 4-6 years. Primary and secondary outcome measures eNO, FEV 1 /FVC, FEF 25{\%}-75{\%}, DRS, atopic sensitisation and allergic diseases. Methods Children completed the modified International Study of Asthma and Allergies in Childhood questionnaire and underwent eNO assessments, spirometry, methacholine bronchial provocation tests and skin prick tests. Recurrent wheeze was defined as having a lifetime wheeze of more than three episodes, based on the questionnaire. The frequency of hospitalisation and emergency room visits was also obtained by means of the questionnaire. Current' wheeze was defined as having symptoms or treatments within the past 12 months. Results The prevalence of recurrent wheeze was 13.4{\%}. Children with recurrent wheeze showed a higher prevalence of lifetime or current allergic rhinitis (p=0.01 and p=0.002, respectively) and lifetime atopic dermatitis (p=0.007). Children with recurrent wheeze showed lower FEV 1 /FVC (p=0.033) and FEF 25{\%}-75{\%} (p=0.004), and higher eNO levels (p=0.013) than those without recurrent wheeze. However, the DRS, prevalence of atopic sensitisation and serum IgE levels were not significantly different between the two groups. Conclusions Recurrent wheeze in preschool children may be associated with airway inflammation and diminished airway function, but not with AHR or atopy.",
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T1 - Recurrent wheeze and its relationship with lung function and airway inflammation in preschool children

T2 - A cross-sectional study in South Korea

AU - Soh, Ji Eun

AU - Kim, Kyung Moon

AU - Kwon, Ji Won

AU - Kim, Hyung Young

AU - Seo, Ju Hee

AU - Kim, Hyo Bin

AU - Lee, So Yeon

AU - Jang, Gwang Cheon

AU - Song, Dae-Jin

AU - Kim, Woo Kyung

AU - Jung, Young Ho

AU - Hong, Soo Jong

AU - Shim, Jung Yeon

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background Relationship between recurrent wheeze and airway function and inflammation in preschool children is not fully known. Objective To investigate the relationship between recurrent wheeze and airway inflammation, lung function, airway hyper-reactivity (AHR) and atopy in preschool children. Design Observational study, comparing forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC) and mid-forced expiratory flow (FEF 25%-75%), dose-response slope (DRS), exhaled nitric oxide (eNO) and atopic sensitisation between children with recurrent wheeze and those without. Setting Population-based, cross-sectional study in Seoul and the Gyeonggi province of Korea conducted as a government-funded programme to perform standardised measurement of the prevalence of allergic diseases, and related factors, in preschool children. Participants 900 children aged 4-6 years. Primary and secondary outcome measures eNO, FEV 1 /FVC, FEF 25%-75%, DRS, atopic sensitisation and allergic diseases. Methods Children completed the modified International Study of Asthma and Allergies in Childhood questionnaire and underwent eNO assessments, spirometry, methacholine bronchial provocation tests and skin prick tests. Recurrent wheeze was defined as having a lifetime wheeze of more than three episodes, based on the questionnaire. The frequency of hospitalisation and emergency room visits was also obtained by means of the questionnaire. Current' wheeze was defined as having symptoms or treatments within the past 12 months. Results The prevalence of recurrent wheeze was 13.4%. Children with recurrent wheeze showed a higher prevalence of lifetime or current allergic rhinitis (p=0.01 and p=0.002, respectively) and lifetime atopic dermatitis (p=0.007). Children with recurrent wheeze showed lower FEV 1 /FVC (p=0.033) and FEF 25%-75% (p=0.004), and higher eNO levels (p=0.013) than those without recurrent wheeze. However, the DRS, prevalence of atopic sensitisation and serum IgE levels were not significantly different between the two groups. Conclusions Recurrent wheeze in preschool children may be associated with airway inflammation and diminished airway function, but not with AHR or atopy.

AB - Background Relationship between recurrent wheeze and airway function and inflammation in preschool children is not fully known. Objective To investigate the relationship between recurrent wheeze and airway inflammation, lung function, airway hyper-reactivity (AHR) and atopy in preschool children. Design Observational study, comparing forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC) and mid-forced expiratory flow (FEF 25%-75%), dose-response slope (DRS), exhaled nitric oxide (eNO) and atopic sensitisation between children with recurrent wheeze and those without. Setting Population-based, cross-sectional study in Seoul and the Gyeonggi province of Korea conducted as a government-funded programme to perform standardised measurement of the prevalence of allergic diseases, and related factors, in preschool children. Participants 900 children aged 4-6 years. Primary and secondary outcome measures eNO, FEV 1 /FVC, FEF 25%-75%, DRS, atopic sensitisation and allergic diseases. Methods Children completed the modified International Study of Asthma and Allergies in Childhood questionnaire and underwent eNO assessments, spirometry, methacholine bronchial provocation tests and skin prick tests. Recurrent wheeze was defined as having a lifetime wheeze of more than three episodes, based on the questionnaire. The frequency of hospitalisation and emergency room visits was also obtained by means of the questionnaire. Current' wheeze was defined as having symptoms or treatments within the past 12 months. Results The prevalence of recurrent wheeze was 13.4%. Children with recurrent wheeze showed a higher prevalence of lifetime or current allergic rhinitis (p=0.01 and p=0.002, respectively) and lifetime atopic dermatitis (p=0.007). Children with recurrent wheeze showed lower FEV 1 /FVC (p=0.033) and FEF 25%-75% (p=0.004), and higher eNO levels (p=0.013) than those without recurrent wheeze. However, the DRS, prevalence of atopic sensitisation and serum IgE levels were not significantly different between the two groups. Conclusions Recurrent wheeze in preschool children may be associated with airway inflammation and diminished airway function, but not with AHR or atopy.

KW - asthma

KW - epidemiology

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