Clinical significance of asthma clusters by longitudinal analysis in Korean asthma cohort

PLoS One. 2013 Dec 31;8(12):e83540. doi: 10.1371/journal.pone.0083540. eCollection 2013.


Background: We have previously identified four distinct groups of asthma patients in KOREAN cohorts using cluster analysis: (A) smoking asthma, (B) severe obstructive asthma, (C) early-onset atopic asthma, and (D) late-onset mild asthma.

Methods and results: A longitudinal analysis of each cluster in a Korean adult asthma cohort was performed to investigate the clinical significance of asthma clusters over 12 months. Cluster A showed relatively high asthma control test (ACT) scores but relatively low FEV1 scores, despite a high percentage of systemic corticosteroid use. Cluster B had the lowest mean FEV1, ACT, and the quality of life questionnaire for adult Korean asthmatics (QLQAKA) scores throughout the year, even though the percentage of systemic corticosteroid use was the highest among the four clusters. Cluster C was ranked second in terms of FEV1, with the second lowest percentage of systemic corticosteroid use, and showed a marked improvement in subjective symptoms over time. Cluster D consistently showed the highest FEV1, the lowest systemic corticosteroid use, and had high ACT and QLQAKA scores.

Conclusion: Our asthma clusters had clinical significance with consistency among clusters over 12 months. These distinctive phenotypes may be useful in classifying asthma in real practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Asthma / classification*
  • Asthma / drug therapy
  • Asthma / physiopathology*
  • Cluster Analysis
  • Cohort Studies
  • Female
  • Forced Expiratory Volume
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Quality of Life
  • Republic of Korea
  • Smoking / adverse effects
  • Smoking / physiopathology
  • Surveys and Questionnaires
  • Young Adult


  • Adrenal Cortex Hormones

Grant support

This study was supported by a grant of the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (grant no. A102065 & HI13C0776). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.