Asthma, COPD and overlap syndrome: a longitudinal study in young European adults

Eur Respir J. 2015 Sep;46(3):671-9. doi: 10.1183/09031936.00008615. Epub 2015 Jun 25.

Abstract

We compared risk factors and clinical characteristics, 9-year lung function change and hospitalisation risk across subjects with the asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS), asthma or COPD alone, or none of these diseases.Participants in the European Community Respiratory Health Survey in 1991-1993 (aged 20-44 years) and 1999-2001 were included. Chronic airflow obstruction was defined as pre-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity<lower limit of normal on both occasions. Based on their history of respiratory symptoms, spirometry and risk factors, subjects were classified as having asthma alone (n=941), COPD alone (n=166), ACOS (n=218) and none of these (n=5659).Subjects with ACOS shared risk factors and clinical characteristics with subjects with asthma alone, but they had an earlier age of asthma onset. FEV1 change in the ACOS group (-25.9 mL·year(-1)) was similar to that in the asthma group (-25.3 mL·year(-1)), and lower (p<0.001) than in the COPD group (-37.3 mL·year(-1)). ACOS was associated with the highest hospitalisation rate.Among young adults aged 20-44 years, ACOS seems to represent a form of severe asthma, characterised by more frequent hospitalisations, and to be the result of early-onset asthma that has progressed to fixed airflow obstruction.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Asthma / diagnosis
  • Asthma / epidemiology*
  • Asthma / therapy
  • Europe / epidemiology
  • Female
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Multivariate Analysis
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Recurrence
  • Respiratory Function Tests
  • Risk Assessment
  • Sex Distribution
  • Spirometry
  • Survival Rate
  • Syndrome
  • Vital Capacity / physiology*
  • Young Adult

Supplementary concepts

  • Pulmonary Disease, Chronic Obstructive, Severe Early-Onset