• Ravi Kalhan, Mark T Dransfield, Laura A Colangelo, Michael J Cuttica, David R Jacobs, Bharat Thyagarajan, EsteparRaul San JoseRSJ6 Applied Chest Imaging Laboratory, Department of Radiology, and., Rola Harmouche, Jorge Onieva Onieva, Samuel Y Ash, Yuka Okajima, Carlos Iribarren, Stephen Sidney, Cora E Lewis, David M Mannino, Kiang Liu, Lewis J Smith, and George R Washko.
• 1 Division of Pulmonary and Critical Care Medicine and.
• Am. J. Respir. Crit. Care Med. 2018 Jun 15; 197 (12): 161616241616-1624.

RationaleThere are limited data on factors in young adulthood that predict future lung disease.ObjectivesTo determine the relationship between respiratory symptoms, loss of lung health, and incident respiratory disease in a population-based study of young adults.MethodsWe examined prospective data from 2,749 participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who completed respiratory symptom questionnaires at baseline and 2 years later and repeated spirometry measurements over 30 years.Measurements And Main ResultsCough or phlegm, episodes of bronchitis, wheeze, shortness of breath, and chest illnesses at both baseline and Year 2 were the main predictor variables in models assessing decline in FEV1 and FVC from Year 5 to Year 30, incident obstructive and restrictive lung physiology, and visual emphysema on thoracic computed tomography scan. After adjustment for covariates, including body mass index, asthma, and smoking, report of any symptom was associated with -2.71 ml/yr excess decline in FEV1 (P < 0.001) and -2.18 in FVC (P < 0.001) as well as greater odds of incident (prebronchodilator) obstructive (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.24-2.14) and restrictive (OR, 1.40; 95% CI, 1.09-1.80) physiology. Cough-related symptoms (OR, 1.56; 95% CI, 1.13-2.16) were associated with greater odds of future emphysema.ConclusionsPersistent respiratory symptoms in young adults are associated with accelerated decline in lung function, incident obstructive and restrictive physiology, and greater odds of future radiographic emphysema.

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