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ORIGINAL ARTICLE
Year : 2012  |  Volume : 7  |  Issue : 2  |  Page : 61-68

Seasons can influence the results of the methacholine challenge test


1 Unit of Pneumology, "Misericordia" Hospital, Grosseto, Italy
2 Institute of Clinical Physiology, National Research Council, Pisa, Italy
3 Department of Physiopathology, Experimental Medicine and Public Health, University of Siena, Italy
4 Unit of Pneumology and UTSIR, "Campo di Marte" Hospital, Lucca, Italy
5 "S. Donato" Hospital, Arezzo, Italy

Correspondence Address:
Bruno Sposato
U.O. Pneumologia, Azienda Ospedaliera "Misericordia", Via Senese 161; 58100 GROSSETO
Italy
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DOI: 10.4103/1817-1737.94521

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Objective: This study tried to evaluate whether a methacholine test may be influenced by the seasons. Methods: We considered 4826 consecutive subjects with normal spirometry (50.53% males; age: 35.1±16.2; forced expiratory volume in one second: 99.5±13.0%) who underwent a methacholine test for suspected asthma symptoms between 2000 and 2010. They were subdivided into four groups, like the seasons, according to the test dates. Results: A total of 1981 (41%) resulted normal (no PD 20 was obtained with 2400 μg of methacholine); the others showed a mean LogPD 20 of 2.52±0.5 μg. The number of subjects with bronchial hyper-responsiveness (BHR) found in autumn (789, 62.3%) was higher than in summer (583, 56.7%; P=0.03). A higher number of females and overweight/obese subjects showed a BHR in autumn compared with the other seasons. The spring mean LogPD 20 value (2.48±0.48 μg) was lower if compared with the one measured in summer (2.59±0.49 μg; P=0.05). LogPD 20 value was lower in females and non-smokers in spring compared with summer (P<0.05). Overweight/obese non-smokers showed a lower LogPD 20 in spring and autumn compared with that in summer (P<0.05). Autumn was a risk factor (OR: 1.378; P=0.001) for BHR (using a PD 20 <2 400 μg as BHR limit), while spring (OR: 1.330; P=0.021) and autumn (OR: 1.331; P=0.020) were risk factors for a more severe BHR (using a PD 20 <400 μg as BHR limit). Conclusion: There was a higher probability of finding BHR in outpatients with suspected asthma in autumn and spring compared with summer. Spring is the season where BHR may be more severe. Females and overweight/obese subjects were those mainly involved in this seasonal variability of BHR.


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