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What does adolescent undiagnosed-wheeze represent? Findings from the Isle of Wight Cohort

What does adolescent undiagnosed-wheeze represent? Findings from the Isle of Wight Cohort
What does adolescent undiagnosed-wheeze represent? Findings from the Isle of Wight Cohort
We sought to characterise adolescent wheeze in the absence of asthma, which we termed “undiagnosed-wheeze”.

The Isle of Wight Birth Cohort (N=1456) was reviewed at 1, 2, 4, 10 and 18-years. Using questionnaire responses, “Asthma” was defined as “ever had asthma” plus either “wheezing in the last 12-months” or “taking asthma treatment in the last 12-months”, “Undiagnosed-wheeze” as “wheeze in the last 12-months” but “no” to “ever had asthma” and remaining subjects termed “non-wheezers”.

Undiagnosed-wheeze (prevalence 4.9%) accounted for 22% of wheezing at 18-years. This was largely adolescent-onset with similar symptom frequency and severity to diagnosed asthma. However, undiagnosed-wheezers had significantly higher FEV1/FVC ratio, less bronchodilator reversibility and bronchial hyper-responsiveness, and were less frequently atopic than asthmatics. Undiagnosed-wheezers had earlier smoking onset, higher smoking rates and monthly paracetamol use than non-wheezers. Logistic regression identified paracetamol use (OR 1.11, [95%CI 1.01–1.23]; p=0.03), smoking at 18-years (2.54, [1.19–5.41], p=0.02), rhinitis at 18 (2.82, [1.38–5.73], p=0.004) and asthmatic family history (2.26, [1.10–4.63], p=0.03) as significant independent risk factors for undiagnosed-wheeze.

Undiagnosed-wheeze is relatively common during adolescence, differs from diagnosed asthma and has strong associations to smoking and paracetamol use. Better recognition of undiagnosed-wheeze and assessment of potential relevance to adult health is warranted.
asthma, lung function, paracetamol, smoking, undiagnosed wheeze, wheezing phenotype
0903-1936
580-588
Raza, Abid
0bcd5946-167e-4e75-9eaf-906e980ee498
Kurukulaaratchy, Ramesh J.
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Grundy, Jane D.
4fb23359-6219-4f59-8ee8-f3f90c8304eb
Clayton, C. Bernie
c409b37a-143e-43d2-800a-796118f152dd
Mitchell, Frances A.
19682b93-d0b2-4851-851c-135d9fc59c90
Roberts, Graham
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Ewart, Susan
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Sadeghnejad, Alireza
e2b0fa73-429f-4818-9f24-127f36c57752
Arshad, S Hasan
917e246d-2e60-472f-8d30-94b01ef28958
Raza, Abid
0bcd5946-167e-4e75-9eaf-906e980ee498
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
Grundy, Jane D.
4fb23359-6219-4f59-8ee8-f3f90c8304eb
Clayton, C. Bernie
c409b37a-143e-43d2-800a-796118f152dd
Mitchell, Frances A.
19682b93-d0b2-4851-851c-135d9fc59c90
Roberts, Graham
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Ewart, Susan
28667421-3cf7-43d7-b1c3-ca27564938f7
Sadeghnejad, Alireza
e2b0fa73-429f-4818-9f24-127f36c57752
Arshad, S Hasan
917e246d-2e60-472f-8d30-94b01ef28958

Raza, Abid, Kurukulaaratchy, Ramesh J., Grundy, Jane D., Clayton, C. Bernie, Mitchell, Frances A., Roberts, Graham, Ewart, Susan, Sadeghnejad, Alireza and Arshad, S Hasan (2012) What does adolescent undiagnosed-wheeze represent? Findings from the Isle of Wight Cohort. European Respiratory Journal, 40 (3), 580-588. (doi:10.1183/09031936.00085111). (PMID:22267759)

Record type: Article

Abstract

We sought to characterise adolescent wheeze in the absence of asthma, which we termed “undiagnosed-wheeze”.

The Isle of Wight Birth Cohort (N=1456) was reviewed at 1, 2, 4, 10 and 18-years. Using questionnaire responses, “Asthma” was defined as “ever had asthma” plus either “wheezing in the last 12-months” or “taking asthma treatment in the last 12-months”, “Undiagnosed-wheeze” as “wheeze in the last 12-months” but “no” to “ever had asthma” and remaining subjects termed “non-wheezers”.

Undiagnosed-wheeze (prevalence 4.9%) accounted for 22% of wheezing at 18-years. This was largely adolescent-onset with similar symptom frequency and severity to diagnosed asthma. However, undiagnosed-wheezers had significantly higher FEV1/FVC ratio, less bronchodilator reversibility and bronchial hyper-responsiveness, and were less frequently atopic than asthmatics. Undiagnosed-wheezers had earlier smoking onset, higher smoking rates and monthly paracetamol use than non-wheezers. Logistic regression identified paracetamol use (OR 1.11, [95%CI 1.01–1.23]; p=0.03), smoking at 18-years (2.54, [1.19–5.41], p=0.02), rhinitis at 18 (2.82, [1.38–5.73], p=0.004) and asthmatic family history (2.26, [1.10–4.63], p=0.03) as significant independent risk factors for undiagnosed-wheeze.

Undiagnosed-wheeze is relatively common during adolescence, differs from diagnosed asthma and has strong associations to smoking and paracetamol use. Better recognition of undiagnosed-wheeze and assessment of potential relevance to adult health is warranted.

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More information

e-pub ahead of print date: 20 January 2012
Published date: September 2012
Keywords: asthma, lung function, paracetamol, smoking, undiagnosed wheeze, wheezing phenotype
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 341588
URI: http://eprints.soton.ac.uk/id/eprint/341588
ISSN: 0903-1936
PURE UUID: b17c8649-dc12-4a4f-8b2b-343b4d000d10
ORCID for Ramesh J. Kurukulaaratchy: ORCID iD orcid.org/0000-0002-1588-2400
ORCID for Graham Roberts: ORCID iD orcid.org/0000-0003-2252-1248

Catalogue record

Date deposited: 30 Jul 2012 10:22
Last modified: 15 Mar 2024 03:22

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Contributors

Author: Abid Raza
Author: Jane D. Grundy
Author: C. Bernie Clayton
Author: Frances A. Mitchell
Author: Graham Roberts ORCID iD
Author: Susan Ewart
Author: Alireza Sadeghnejad
Author: S Hasan Arshad

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