{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T23:01:13Z","timestamp":1794092473527,"version":"4.8.0"},"reference-count":34,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/P005918\/1"],"award-info":[{"award-number":["MR\/P005918\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"New Zealand Ministry of Business, Innovation and Employment","award":["No award number"],"award-info":[{"award-number":["No award number"]}]},{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["16-604"],"award-info":[{"award-number":["16-604"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Aging","award":["R01AG032282"],"award-info":[{"award-number":["R01AG032282"]}]},{"name":"National Institute of Aging","award":["R01AG069936"],"award-info":[{"award-number":["R01AG069936"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"accepted":{"date-parts":[[2024,2,10]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec><jats:title>Rationale<\/jats:title><jats:p>Life course trajectories of lung function development and decline influence the risk for lung disease but are poorly documented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To document lung function trajectories from childhood to mid-adult life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We modelled forced expiratory volume in 1 s (FEV<jats:sub>1<\/jats:sub>), forced vital capacity (FVC) and FEV<jats:sub>1<\/jats:sub>\/FVC at ages 9, 11, 13, 15, 18, 21, 26, 32, 38 and 45 years from a population-based cohort using latent profile analysis to identify distinct subgroups of participants with similar lung function trajectories. Regression analyses were used to assess associations between the trajectories, early life factors and postbronchodilator airflow obstruction at age 45.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 865 participants with \u22656 measures of lung function, we identified 10 distinct FEV<jats:sub>1<\/jats:sub>trajectories. Most were approximately parallel except for a childhood airway hyper-responsiveness-related persistently low trajectory (3% of study population); two accelerated-decline trajectories, one of which (8%) was associated with smoking and higher adult body mass index (BMI) and a catch-up trajectory (8%). Findings for FEV<jats:sub>1<\/jats:sub>\/FVC trajectories were similar. Nine trajectories were identified for FVC: most were also approximately parallel except for a higher BMI-related accelerated-decline trajectory. The three FEV<jats:sub>1<\/jats:sub>trajectories leading to the lowest FEV<jats:sub>1<\/jats:sub>values comprised 19% of the cohort but contributed 55% of airflow obstruction at age 45.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lung function trajectories to mid-adult life are largely established before adolescence, with a few exceptions: a childhood airway hyper-responsiveness-related persistently low trajectory, which starts low and gets worse with age, and accelerated adult decline trajectories associated with smoking and obesity. Adverse trajectories are associated with a high risk of airflow obstruction in mid-adult life.<\/jats:p><\/jats:sec>","DOI":"10.1136\/thorax-2023-220436","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T17:31:01Z","timestamp":1710783061000},"page":"754-761","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Distinct trajectories of lung function from childhood to mid-adulthood"],"prefix":"10.1136","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4745-6245","authenticated-orcid":false,"given":"Xian","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-2194","authenticated-orcid":false,"given":"Andrew R","family":"Gray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3922-7144","authenticated-orcid":false,"given":"Robert J","family":"Hancox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"key":"2025042101250781000_79.8.754.1","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/S2213-2600(18)30529-0","article-title":"Lung function trajectories in health and disease","volume":"7","author":"Agusti","year":"2019","journal-title":"Lancet Respir Med"},{"key":"2025042101250781000_79.8.754.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6077.1645"},{"key":"2025042101250781000_79.8.754.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411532"},{"key":"2025042101250781000_79.8.754.4","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/S2213-2600(17)30434-4","article-title":"Lung function in early adulthood and health in later life: a transgenerational cohort analysis","volume":"5","author":"Agust\u00ed","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2025042101250781000_79.8.754.5","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1164\/rccm.201608-1561LE","article-title":"Low lung function in young adult life is associated with early mortality","volume":"195","author":"Vasquez","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2025042101250781000_79.8.754.6","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1164\/rccm.201604-0753OC","article-title":"A distinct low lung function trajectory from childhood to the fourth decade of life","volume":"194","author":"Berry","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"2025042101250781000_79.8.754.7","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/S2213-2600(18)30100-0","article-title":"Childhood predictors of lung function trajectories and future COPD risk: a prospective cohort study from the first to the sixth decade of life","volume":"6","author":"Bui","year":"2018","journal-title":"Lancet Respir Med"},{"key":"2025042101250781000_79.8.754.8","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/S2213-2600(18)30099-7","article-title":"Lung function trajectories from pre-school age to adulthood and their associations with early life factors: a retrospective analysis of three population-based birth cohort studies","volume":"6","author":"Belgrave","year":"2018","journal-title":"Lancet Respir Med"},{"key":"2025042101250781000_79.8.754.9","doi-asserted-by":"crossref","DOI":"10.1186\/s12931-019-1068-0","article-title":"Distinctive lung function Trajectories from age 10 to 26 years in men and women and associated early life risk factors - 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