{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:25:20Z","timestamp":1790256320922,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,4,16]],"date-time":"2014-04-16T00:00:00Z","timestamp":1397606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cluster analyses have enhanced understanding of the heterogeneity of both paediatric and adult wheezing. However, while adolescence represents an important transitional phase, the nature of young adult wheeze has yet to be clearly characterised.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To use cluster analysis to define, for the first time, clinically relevant young adult wheeze clusters in a longitudinal birth cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>K\u2010means cluster analysis was undertaken among 309 currently wheezing subjects at 18 years in the Isle of Wight birth cohort (<jats:italic>N<\/jats:italic>\u00a0=\u00a01456). Thirteen disease\u2010characterising clustering variables at 18 years were used. Resulting clusters were then further characterised by severity indices plus potential risk factors for wheeze development throughout the 1st 18 years of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six wheeze clusters were identified. Cluster 1 (12.3%) <jats:italic>male\u2010early\u2010childhood\u2010onset\u2010atopic\u2010wheeze\u2010with\u2010normal\u2010lung\u2010function<\/jats:italic> had male predominance, normal spirometry, low bronchodilator reversibility (<jats:styled-content style=\"fixed-case\">BDR<\/jats:styled-content>), intermediate bronchial hyper\u2010responsiveness (<jats:styled-content style=\"fixed-case\">BHR<\/jats:styled-content>), high atopy prevalence and more admissions. Cluster 2 (24.2%) <jats:italic>early\u2010childhood\u2010onset\u2010wheeze\u2010with\u2010intermediate\u2010lung\u2010function<\/jats:italic> had no specific sex association, intermediate spirometry, <jats:styled-content style=\"fixed-case\">BDR<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> BHR<\/jats:styled-content>, more significant <jats:styled-content style=\"fixed-case\">BTS<\/jats:styled-content> step therapy and admissions. Cluster 3 (9.7%) <jats:italic>female\u2010early\u2010childhood\u2010onset\u2010atopic\u2010wheeze\u2010with\u2010impaired\u2010lung\u2010function<\/jats:italic> showed female predominance, high allergic disease comorbidity, more severe <jats:styled-content style=\"fixed-case\">BDR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">BHR<\/jats:styled-content>, greatest airflow obstruction, high smoking prevalence, higher symptom severity and admissions. Cluster 4 (19.4%) <jats:italic>female\u2010undiagnosed\u2010wheezers<\/jats:italic> had adolescent\u2010onset non\u2010atopic wheeze, low <jats:styled-content style=\"fixed-case\">BDR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">BHR<\/jats:styled-content>, impaired but non\u2010obstructed spirometry, high symptom frequency and highest smoking prevalence. Cluster 5 (24.6%) <jats:italic>female\u2010late\u2010childhood\u2010onset\u2010wheeze\u2010with\u2010normal\u2010lung\u2010function<\/jats:italic> showed no specific atopy association, normal spirometry, low <jats:styled-content style=\"fixed-case\">BDR<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> BHR<\/jats:styled-content> and symptom severity. Cluster 6 (9.7%) <jats:italic>male\u2010late\u2010childhood\u2010onset\u2010atopic\u2010wheeze\u2010with\u2010impaired\u2010lung\u2010function<\/jats:italic> had high atopy and rhinitis prevalence, increased <jats:styled-content style=\"fixed-case\">BDR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">BHR<\/jats:styled-content>, moderately impaired spirometry, high symptom severity and higher <jats:styled-content style=\"fixed-case\">BTS<\/jats:styled-content> step therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Clinical Relevance<\/jats:title><jats:p>Young adult wheeze is diverse and can be classified into distinct clusters. More severe clusters merit attention and are associated with childhood onset, atopy, impaired lung function and in some, smoking. Smoking\u2010associated undiagnosed wheezers also merit recognition. Better understanding of young adult wheeze could facilitate better later adult respiratory health.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.12306","type":"journal-article","created":{"date-parts":[[2014,3,22]],"date-time":"2014-03-22T09:00:43Z","timestamp":1395478843000},"page":"724-735","source":"Crossref","is-referenced-by-count":14,"title":["The diversity of young adult wheeze: a cluster analysis in a longitudinal birth cohort"],"prefix":"10.1111","volume":"44","author":[{"given":"R. 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