Living with a smoker before age 13 was associated with increased odds of COPD in adulthood among US Hispanic/Latino adults (OR 1.4; 95% CI 1.0-1.9; P=0.024).
Cohort (n=14,854)
Yes
Do early life respiratory risk factors reduce lung function and increase COPD risk in US Hispanic/Latino adults?
Early life respiratory exposures are prevalent in U.S. Hispanic/Latino adults and are significantly associated with lower lung function and greater risk of COPD in adulthood.
Effect estimate: OR 1.4 (95% CI 1.0-1.9)
p-value: p=0.024
Abstract Rationale Adverse early life exposures may impair lung development, limit lung function, and increase vulnerability to later harmful exposures. These exposures differ across Hispanic/Latino heritage groups and compared with non-Hispanic U.S. adults. How such differences contribute to heterogeneity in chronic obstructive pulmonary disease (COPD) burden among Hispanic/Latino groups remains unclear. We investigated the association of early life exposures with lung function in a large cohort of U.S. Hispanics/Latinos. Methods The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) recruited participants aged 18-74 years in 2008-2011 from four U.S. sites (Bronx, Miami, Chicago, San Diego). This analysis was limited to participants with valid baseline spirometry and complete exposure and covariate information. Baseline questionnaires assessed living with a smoker before age 13, parental respiratory disease (asthma or COPD), childhood asthma, and childhood pneumonia or bronchitis before age 18. These four factors were used to classify an early life respiratory risk score (range: 0-4). Outcomes included pre-bronchodilator FEV₁/FVC and COPD, defined as post-bronchodilator FEV₁/FVC 0.70. Survey-weighted regression models were adjusted for age, sex, field center, Hispanic/Latino heritage, BMI, U.S. nativity, adulthood smoking, and physician-diagnosed lifetime asthma. Results Among 14,854 participants, the median age at baseline was 39.4 years (IQR: 27.9, 51.1), 52.0% were women, 77.3% were born outside of the 50 U.S. states/DC, and the largest heritage subgroups were Mexican (38.8%) and Cuban (20.4%). Mean (SD) pre-bronchodilator FEV₁/FVC was 0.81 (0.001) and 475 (2.8%) had COPD. Overall, 50.9% of participants lived with a smoker before age 13, 16.4% reported parental respiratory disease, 11.2% had childhood asthma, and 2.3% reported childhood pneumonia or bronchitis. Prevalence of early life exposures and COPD varied by Hispanic/Latino group (P 0.001 for all comparisons, Figure 1), with people of Cuban and Puerto Rican having greater burdens. Higher early life respiratory risk score was associated with lower lung function and higher COPD risk. When examining individual early life risk factors, lower pre-bronchodilator FEV₁/FVC was associated with childhood asthma (β = -0.01; 95% CI: -0.02, -0.002; P = 0.018) and childhood pneumonia or bronchitis (β = -0.02; 95% CI: -0.03, -0.01; P = 0.001). Increased odds of COPD were associated with living with a smoker before age 13 (OR = 1.4; 95% CI: 1.0, 1.9; P = 0.024). Conclusions Early life respiratory exposures were prevalent in U.S. Hispanic/Latino adults, particularly certain heritage groups, and they were associated with lower lung function and greater risk of COPD in adulthood. This abstract is funded by: NIH
Ma et al. (Fri,) conducted a cohort in Chronic obstructive pulmonary disease (COPD) (n=14,854). Early life respiratory exposures (e.g., living with a smoker before age 13) vs. No early life respiratory exposures was evaluated on COPD (post-bronchodilator FEV1/FVC <0.70) (OR 1.4, 95% CI 1.0-1.9, p=0.024). Living with a smoker before age 13 was associated with increased odds of COPD in adulthood among US Hispanic/Latino adults (OR 1.4; 95% CI 1.0-1.9; P=0.024).
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