{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T06:52:10Z","timestamp":1763967130517,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,1,24]],"date-time":"2021-01-24T00:00:00Z","timestamp":1611446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","award":["POCI-01-0145-36 FEDER-029130"],"award-info":[{"award-number":["POCI-01-0145-36 FEDER-029130"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13\u201317 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes\/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper\/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p &lt; 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations\/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.<\/jats:p>","DOI":"10.3390\/ijerph18031015","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T02:07:00Z","timestamp":1611540420000},"page":"1015","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Profiling Persistent Asthma Phenotypes in Adolescents: A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0233-830X","authenticated-orcid":false,"given":"Rita","family":"Amaral","sequence":"first","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, 4200-072 Porto, Portugal"},{"name":"Department of Women\u2019s and Children\u2019s Health, Paediatric Research, Uppsala University, SE-751 05 Uppsala, Sweden"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1151-8791","authenticated-orcid":false,"given":"Cristina","family":"J\u00e1come","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7755-5002","authenticated-orcid":false,"given":"Rute","family":"Almeida","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-0932","authenticated-orcid":false,"given":"Ana Margarida","family":"Pereira","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Allergy Unit, CUF Porto Hospital and Institute, 4100-180 Porto, Portugal"}]},{"given":"Magna","family":"Alves-Correia","sequence":"additional","affiliation":[{"name":"Allergy Unit, CUF Porto Hospital and Institute, 4100-180 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2061-7844","authenticated-orcid":false,"given":"Sandra","family":"Mendes","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"given":"Jos\u00e9 Carlos Cidrais","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital Pedro Hispano, Unidade Local de Sa\u00fade de Matosinhos, 4464-513 Matosinhos, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6561-2153","authenticated-orcid":false,"given":"Joana","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital Pedro Hispano, Unidade Local de Sa\u00fade de Matosinhos, 4464-513 Matosinhos, Portugal"}]},{"given":"Lu\u00eds","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Allergy Unit, CUF Porto Hospital and Institute, 4100-180 Porto, Portugal"}]},{"given":"Alberto","family":"Costa","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital Senhora da Oliveira, 4835-044 Guimar\u00e3es, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7580-1166","authenticated-orcid":false,"given":"Armandina","family":"Silva","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital Senhora da Oliveira, 4835-044 Guimar\u00e3es, Portugal"}]},{"given":"Maria Fernanda","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universit\u00e1rio do Porto, 4099-001 Porto, Portugal"}]},{"given":"Manuel","family":"Ferreira-Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Servi\u00e7o de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universit\u00e1rio do Porto, 4099-001 Porto, Portugal"}]},{"given":"Rodrigo Rodrigues","family":"Alves","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Hospital do Divino Esp\u00edrito Santo, 9500-370 Ponta Delgada, Portugal"}]},{"given":"Ana Sofia","family":"Moreira","sequence":"additional","affiliation":[{"name":"Unidade de Imunoalergologia, Hospital do Divino Esp\u00edrito Santo, 9500-370 Ponta Delgada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7253-6475","authenticated-orcid":false,"given":"Ricardo M.","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1374-4327","authenticated-orcid":false,"given":"Ros\u00e1rio","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal"}]},{"given":"Paula Leiria","family":"Pinto","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Hospital de Dona Estef\u00e2nia, Centro Hospitalar Universit\u00e1rio de Lisboa Central, 1150-199 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5149-7473","authenticated-orcid":false,"given":"Nuno","family":"Neuparth","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Hospital de Dona Estef\u00e2nia, Centro Hospitalar Universit\u00e1rio de Lisboa Central, 1150-199 Lisboa, Portugal"},{"name":"Pathophysiology, CHRC\/CEDOC, High Burden and High Mortality Diseases Thematic Line Coordinator, Nova Medical School, 1150-190 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0864-3612","authenticated-orcid":false,"given":"Diana","family":"Bordalo","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Unidade Hospitalar de Famalic\u00e3o, Centro Hospitalar do M\u00e9dio Ave, 4780-371 Vila Nova de Famalic\u00e3o, Portugal"}]},{"given":"Ana Todo","family":"Bom","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Centro Hospitalar e Universit\u00e1rio de Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"Maria Jos\u00e9","family":"C\u00e1lix","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital de S\u00e3o Teot\u00f3nio, Centro Hospitalar Tondela\u2013Viseu, 3504-509 Viseu, Portugal"}]},{"given":"T\u00e2nia","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Unidade de Sa\u00fade Familiar Progresso e Sa\u00fade, ACeS Baixo Mondego, 3060-716 Tocha, Portugal"}]},{"given":"Joana","family":"Gomes","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Unidade I, Centro Hospitalar Vila Nova de Gaia\/Espinho, 4434-502 Vila Nova de Gaia, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2844-2754","authenticated-orcid":false,"given":"Carmen","family":"Vidal","sequence":"additional","affiliation":[{"name":"Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, 15706 Santiago De Compostela, Spain"}]},{"given":"Ana","family":"Mendes","sequence":"additional","affiliation":[{"name":"Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal"}]},{"given":"Maria Jo\u00e3o","family":"Vasconcelos","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200\u2013319 Porto, Portugal"}]},{"given":"Pedro Morais","family":"Silva","sequence":"additional","affiliation":[{"name":"Imunoalergologia, Grupo HPA Sa\u00fade, 8500-322 Portim\u00e3o, Portugal"}]},{"given":"Jos\u00e9","family":"Ferraz","sequence":"additional","affiliation":[{"name":"Imunoalergologia, Hospital Privado de Alfena, Trofa Sa\u00fade, 4445-243 Alfena, Portugal"}]},{"given":"Ana","family":"Mor\u00eate","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Hospital Infante D. Pedro, Centro Hospitalar Baixo Vouga, 3814-501 Aveiro, Portugal"}]},{"given":"Cla\u00fadia Sofia","family":"Pinto","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pneumologia, Hospital S\u00e3o Pedro de Vila Real, Centro Hospitalar De Tr\u00e1s-Os-Montes E Alto Douro, 5000-508 Vila Real, Portugal"}]},{"given":"Natacha","family":"Santos","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Portim\u00e3o, Portugal"}]},{"given":"Cla\u00fadia Chaves","family":"Loureiro","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pneumologia, Hospitais da Universidade de Coimbra, 3000-076 Coimbra, Portugal"}]},{"given":"Ana","family":"Arrobas","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pneumologia, Centro Hospitalar e Universit\u00e1rio de Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2241-7889","authenticated-orcid":false,"given":"Maria Lu\u00eds","family":"Marques","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Centro Hospitalar Universit\u00e1rio do Porto, 4099-001 Porto, Portugal"}]},{"given":"Carlos","family":"Lozoya","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Sa\u00fade de Castelo Branco, 6000-085 Castelo Branco, Portugal"}]},{"given":"Cristina","family":"Lopes","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital Pedro Hispano, Unidade Local de Sa\u00fade de Matosinhos, 4464-513 Matosinhos, Portugal"},{"name":"Imunologia B\u00e1sica e Cl\u00ednica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal"}]},{"given":"Francisca","family":"Cardia","sequence":"additional","affiliation":[{"name":"Unidade de Sa\u00fade Familiar Terras de Azurara, ACES D\u00e3o Laf\u00f5es, 3530-113 Mangualde, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6326-8173","authenticated-orcid":false,"given":"Carla Chaves","family":"Loureiro","sequence":"additional","affiliation":[{"name":"Departamento de Pediatria, Servi\u00e7o de Pediatria Ambulat\u00f3ria, Centro Hospitalar e Universit\u00e1rio de Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7281-0406","authenticated-orcid":false,"given":"Raquel","family":"C\u00e2mara","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pneumologia, Hospital Nossa Senhora do Ros\u00e1rio, Centro Hospitalar Barreiro Montijo, 2834-003 Barreiro, Portugal"}]},{"given":"In\u00eas","family":"Vieira","sequence":"additional","affiliation":[{"name":"UCSP Dr. Arnaldo Sampaio, ACES Pinhal Litoral, 2419-014 Leiria, Portugal"}]},{"given":"Sofia da","family":"Silva","sequence":"additional","affiliation":[{"name":"USF Cuidarte, Unidade Local de Sa\u00fade do Alto Minho, 4925-083 Portuzelo, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2925-2618","authenticated-orcid":false,"given":"Eurico","family":"Silva","sequence":"additional","affiliation":[{"name":"Unidade de Sa\u00fade Familiar Jo\u00e3o Semana, ACeS Baixo Vouga, 3880-225 Ovar, Portugal"}]},{"given":"Natalina","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Unidade de Sa\u00fade Familiar Mondego, ACES Baixo Mondego, 3045-059 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0887-8796","authenticated-orcid":false,"given":"Jo\u00e3o A.","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Allergy Unit, CUF Porto Hospital and Institute, 4100-180 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.5588\/ijtld.14.0170","article-title":"Global burden of asthma among children","volume":"18","author":"Asher","year":"2014","journal-title":"Int. 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