Preschool-age wheezing phenotypes and asthma persistence in adolescents

Helena Pite, Angela Gaspar, Mario Morais-Almeida

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Predicting long-term outcomes in individuals with childhood wheezing is of major clinical relevance. Objective: To identify and characterize childhood wheezing phenotypes related to asthma persistence in adolescence with a multidimensional statistical model, independent of predefined hypotheses. Methods: This prospective cohort study included 308 children, ages textless7 years, with recurrent wheezing. We systematically evaluated asthma prevalence in children at 3, 8, and 13 years of follow-ups. Risk factors associated with asthma persistence in adolescence were analyzed with multivariable logistic regression. Early childhood wheezing phenotypes were identified with k-means cluster analysis of variables selected with the logistic regression analysis, which were based on questionnaires and skin-prick tests. These phenotypes were compared for predicting asthma prevalence, use of control treatments, and lung function in childhood and adolescence. Results: Asthma prevalence was 58.3% (n = 249) and 53.5% (n = 170) at the 8- and 13-year follow-ups, respectively. Preschool-age diagnoses of atopy (odds ratio 11.8 [95% confidence interval, 4.0-34.6]) and rhinitis (odds ratio 10.4 [95% confidence interval, 3.7-29.1]) were independent risk factors for asthma persistence in adolescence. We identified three early childhood wheezing phenotypes: transient, persistent atopic, and persistent nonatopic. The latter two were characterized by rhinitis during preschool age. These phenotypes could predict the following outcomes: asthma symptom persistence, use of control treatments, and lung function during childhood and adolescence (p textless 0.03). Conclusion: Asthma persistence through adolescence reflected different wheezing phenotypes based on preschool-age comorbidities, particularly rhinitis, with or without atopy. Our results supported that wheezing phenotypes, identified at early ages from simple measurements, could predict asthma and lung function outcomes.
Original languageEnglish
Pages (from-to)231-241
Number of pages11
JournalALLERGY AND ASTHMA PROCEEDINGS
Volume37
Issue number3
DOIs
Publication statusPublished - May 2016

Keywords

  • Allergy

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