To our knowledge, this is the first study to characterise lifetime phenotypes of obstruction
and restriction simultaneously using objective data-driven techniques and unique life
course spirometry measures of FEV1/FVC ratio and FVC from childhood to middle age.
Mixed and obstructive-only patterns indicate those who might benefit from early COPD
interventions. Those with the restrictive-only pattern had evidence of true lung restriction
and were at increased risk of multimorbidity by middle age.