Ethnic Differences in the Effect of Asthma on Pulmonary Function in Children

Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033, USA.
American Journal of Respiratory and Critical Care Medicine (Impact Factor: 13). 10/2010; 183(5):596-603. DOI: 10.1164/rccm.200912-1863OC
Source: PubMed


The impact of asthma on chronic lung function deficits is well known. However, there has been little study of ethnic differences in these asthma-associated deficits.
To examine whether there are ethnic differences in the effects of asthma on children's lung function.
We evaluated the impact of asthma on lung function in 3,245 Hispanic and non-Hispanic white school children (age 10-18 yr) in a longitudinal analysis of the Southern California Children's Health Study. Sex-specific mixed-effects regression spline models were fitted separately for each ethnic group.
Large deficits in flows were observed among children with asthma diagnosed before age 4 years regardless of ethnicity. Hispanic girls with asthma had greater deficits in flows than non-Hispanic girls and were largest for maximal midexpiratory flow (-5.13% compared with -0.58%, respectively). A bigger impact of asthma in Hispanic girls was also found for FEV(1), FEF(75), and PEF (P value 0.04, 0.07, and 0.005, respectively). These ethnic differences were limited to girls diagnosed after age 4 years. In boys, asthma was also associated with greater deficits in flows among Hispanic than in non-Hispanic white children (differences that were not statistically significant). Ethnic differences in prevalence of pets and pests in the home, health insurance coverage, parental education, and smoking did not explain the pattern of lung function differences.
Larger asthma-associated lung function deficits in Hispanics, especially among girls, merit further investigation to determine public health implications and to identify causes amenable to intervention.

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Available from: Yue Zhang, Apr 08, 2014
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    • "Ethnic differences may also play a role in pulmonary function in child asthma. Hispanic girls with asthma have a larger flow deficit than non-Hispanic girls and have larger reductions in FEF 75% , FEV 1 , and PEF [19]. Further investigations are needed to evaluate ethnic differences in the concave pattern of the MEFV curve in adult patients with bronchial asthma. "
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    ABSTRACT: Background. In patients with bronchial asthma, spirometry could identify the airflow limitation of small airways by evaluating the concave shape of the maximal expiratory flow-volume (MEFV) curve. As the concave shape of the MEFV curve is not well documented, we reevaluated the importance of this curve in adult asthmatic patients. Methods. We evaluated spirometric parameters, the MEFV curve, and its concave shape (scoop between the peak and endpoint of expiration) in 27 nonsmoking asthmatic patients with physician-confirmed wheeze and positive bronchial reversibility after a short-acting β2-agonist inhalation. We also calculated angle β and shape factors (SF(25%) and SF(50%)) to quantitate the curvilinearity of the MEFV curve. Results. The MEFV curve was concave in all patients. Along with improvements in standard spirometric parameters, curvilinear parameters, angle β, SF(25%), and SF(50%) were significantly improved after bronchodilator inhalation. There were significant correlations between improvements in angle β, and FEF(50%), and FEF(25-75%), and between improvements in SF(25%), and SF(50%), and FEF(75%). Conclusions. The bronchodilator greatly affected the concave shape of the MEFV curve, correlating with spirometric parameters of small airway obstructions (FEF(50%), FEF(75%), and FEF(25-75%)). Thus, the concave shape of the MEFV curve is an important indicator of airflow limitation in adult asthmatic patients.
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