Lawlor D A, Ebrahim S, Davey Smith G
Department of Social Medicine, University of Bristol, Bristol BS8 2PR, UK.
Thorax. 2005 Oct;60(10):851-8. doi: 10.1136/thx.2005.042408. Epub 2005 Jul 29.
The aim of this study was to examine the associations between birth weight and lung function in a cohort of women aged 60-79 years and to combine these results with those from other published studies in a systematic review and meta-analysis.
The associations of self-reported birth weight with adult lung function (forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and forced expiratory flow rate during mid expiration (FEF(25-75)), all measured using standard procedures, were assessed in a cross sectional study of 2257 British women aged 60-79 years. A detailed literature search was used to identify all published studies of the association, and meta-analysis was used to pool the results from our study and all published studies.
There were positive linear associations between birth weight and all three measures of lung function in simple age and examining nurse adjusted regression models. However, with adjustment for height (squared), all three associations attenuated towards the null: adjusted (age, nurse, height2) change in FEV1 per 1 kg birth weight was 0.01 l (95% CI -0.02 to 0.04); in FVC was 0.02 l (95% CI -0.02 to 0.07), and in FEF(25-75) was 0.00 l (95% CI -0.04 to 0.04). Further adjustment for life course socioeconomic position, adult body mass index, and smoking did not alter these associations. The results were similar among life long non-smokers and those who had ever smoked. A meta-analysis of eight studies of adults suggested that there was a positive association between birth weight and FEV1: pooled increase in FEV1 per 1 kg in birth weight 0.048 l (95% CI 0.026 to 0.070) adjusted for age, smoking, and height (or height squared). There was no evidence of small study bias in this meta-analysis.
There is a modest positive association between birth weight and lung function which indicates that intrauterine factors might have a role in lung development.
本研究旨在调查60 - 79岁女性队列中出生体重与肺功能之间的关联，并将这些结果与其他已发表研究的结果相结合，进行系统评价和荟萃分析。
在一项对2257名60 - 79岁英国女性的横断面研究中，评估了自我报告的出生体重与成人肺功能（使用标准程序测量的1秒用力呼气量（FEV1）、用力肺活量（FVC）和呼气中期用力呼气流量（FEF(25 - 75)））之间的关联。通过详细的文献检索来识别所有已发表的关于该关联的研究，并使用荟萃分析来汇总我们的研究结果和所有已发表研究的结果。
在简单年龄和经检查护士调整的回归模型中，出生体重与所有三项肺功能指标之间存在正线性关联。然而，在对身高（平方）进行调整后，所有三项关联均向无效值减弱：每1千克出生体重的调整后（年龄、护士、身高²）FEV1变化为0.01升（95%置信区间 -0.02至0.04）；FVC为0.02升（95%置信区间 -0.02至0.07），FEF(25 - 75)为0.00升（95%置信区间 -0.04至0.04）。对生命历程社会经济地位、成人体重指数和吸烟进行进一步调整并未改变这些关联。在终身不吸烟者和曾经吸烟者中结果相似。对八项成人研究的荟萃分析表明，出生体重与FEV1之间存在正关联：经年龄、吸烟和身高（或身高平方）调整后，每1千克出生体重的FEV1汇总增加量为0.048升（95%置信区间0.026至0.070）。在该荟萃分析中没有小研究偏倚的证据。
出生体重与肺功能之间存在适度的正关联，这表明宫内因素可能在肺发育中起作用。
