Signs of COPD Can Start Appearing in Young Adulthood
Individuals who smoke begin to show signs of irreversible airway obstruction during their early twenties, indicating an increased risk of developing chronic obstructive pulmonary disease (COPD), according to a new study.
Findings from the study were presented at the American Academy of Allergy, Asthma & Immunology/World Allergy Organization Joint Congress 2018, which is taking place from March 2 to 5, 2018, in Orlando, Florida.
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For their study, the researchers evaluated a cohort of 1456 individuals who were recruited between 1989 and 1990 and assessed at birth and ages 1, 2, 4, 10, 18, and 26 years for asthma, allergic diseases, and associated environmental exposures.
Standardized methodology was used to perform spirometric lung function tests at ages 18 (n = 839) and 26 years (n = 555) before and after treatment with an inhaled bronchodilator (500 ug salbutamol).
The researchers compared various lung function measures between current and never smokers, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio and mid-expiratory flows (FEF25-75) at age 26 years, as well as changes in these indices between ages 18 and 26 years.
The researchers observed no difference in pre-bronchodilator lung function values for smokers vs non-smokers. However, results indicated that post-bronchodilator FEV1 was significantly lower in smokers vs non-smokers between ages 18 and 26 years, with a mean difference in liters of -0.15 vs -0.02. As a result, smokers also had a significantly lower FEV1/FVC ratio by age 26 years compared with non-smokers (0.77 vs 0.81).
In addition, the researchers found that mid-expiratory flows were lower in smokers vs non-smokers at age 26 years (3.98 vs. 4.43).
“There is evidence of airways obstruction in smokers with reduction in both small and large airways occurring in early twenties that is relatively irreversible to bronchodilator even at this early age,” the researchers concluded. “Identification of those who are highly sensitive to tobacco smoke should lead to strategies aiming to prevent long term lung damage.”
Holloway JW, Hodgekiss C, Roberts G, et al. Fixed airways obstruction in smokers at 26 years of age; an early indication of COPD? J Allergy Clin Immunol. 2018;141(2):AB8. https://doi.org/10.1016/j.jaci.2017.12.026.