Seasonal fluctuation of lung function in cystic fibrosis: A national register-based study in two northern European populations

Many risk factors for lung disease in cystic fibrosis (CF) display a seasonal pattern yet it is unclear whether this is reflected in seasonal fluctuations in lung function. We conducted a longitudinal study using CF registries in Denmark and the UK. 471 individuals with a median of 104 FEV1 measurem...

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Bibliographic Details
Published in:Journal of cystic fibrosis 2019-05, Vol.18 (3), p.390-395
Main Authors: Qvist, Tavs, Schlüter, Daniela K., Rajabzadeh, Vian, Diggle, Peter J., Pressler, Tania, Carr, Siobhán B., Taylor-Robinson, David
Format: Article
Language:English
Subjects:
Adolescent
Child
Correlation of Data
Cystic Fibrosis - diagnosis
Cystic Fibrosis - epidemiology
Cystic Fibrosis - physiopathology
Cystic Fibrosis - therapy
Denmark - epidemiology
Female
Fluctuation
Hospitalization - statistics & numerical data
Humans
Longitudinal Studies
Male
Percent predicted FEV1
Respiratory Function Tests - methods
Respiratory Function Tests - statistics & numerical data
Season
Seasonality
Seasons
United Kingdom - epidemiology
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Summary:Many risk factors for lung disease in cystic fibrosis (CF) display a seasonal pattern yet it is unclear whether this is reflected in seasonal fluctuations in lung function. We conducted a longitudinal study using CF registries in Denmark and the UK. 471 individuals with a median of 104 FEV1 measurements per person and 7586 individuals with a median of nine FEV1 measures per person were included from Denmark and the UK respectively. We estimated the effect of seasonality on percent predicted FEV1 trajectories using mixed effects models whilst adjusting for clinically important covariates. We found no significant cyclical seasonal variation in lung function in either country. The maximum variation in percent predicted FEV1 around the yearly average was estimated to be 0.1 percentage points (95%CI 0 to 0.21) and 0.14 percentage points (95%CI 0 to 0.29) in Denmark and the UK, respectively. When considering possible step-like changes between the four seasons, we found that lung function was higher in spring compared to winter in the UK (0.34 percentage points, 95%CI 0.1 to 0.59) though the difference was not of clinical significance. In both the UK and Denmark there may be small seasonal changes in lung function but this effect is not of clinical importance. •It is not well understood how the four seasons affect lung function in CF.•We performed a longitudinal analysis in the UK and Danish CF populations.•Forty years of data were included in a comprehensive mixed effects models.•The seasonal variation was small and not clinically important.
ISSN:1569-1993
1873-5010
DOI:10.1016/j.jcf.2018.10.006