Orfei L, Strachan D P, Rudnicka A R, Wadsworth M E J
Division of Community Health Sciences, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.
Arch Dis Child. 2008 Jul;93(7):570-4. doi: 10.1136/adc.2006.112201. Epub 2007 Jul 11.
To compare adult lung function in two national British cohorts, born in 1946 and 1958, in relation to birth weight, postnatal growth and early air-pollution exposure.
Persons born in England, Scotland and Wales during 1 week in March 1946 and in 1958 and followed from childhood into adult life.
Forced expiratory volume in 1 sec (FEV(1)) and forced vital capacity (FVC), measured at age 43 years on subjects born in 1946 (n = 2167) and age 44-45 years on subjects born in 1958 (n = 5947). Spirometric indices were adjusted for gender, adult standing height, smoking history and socioeconomic position in childhood, and analysed in relation to birth weight, growth pattern and area of birth, classified into four groups of differing exposure to domestic coal smoke pollution.
Within each cohort, FEV(1) and FVC were positively associated with birth weight and proportional sitting height independent of adult height. Pooling results for both cohorts, the mutually adjusted increment in FEV(1) per 1SD increment was 30 ml (95% CI 16 to 45) for birth weight and 19 ml (95% CI 5 to 33) for proportional sitting height. The proportion of adult height attained by age 7 years and early air-pollution exposure were unrelated to adult lung function.
A small but significant influence of birth weight and trunk size on lung function is confirmed, but neither differences in prenatal and postnatal growth nor differences in childhood air-pollution exposure are likely explanations of the differences in spirometric performance between British adults born in 1946 and 1958.
比较英国两个分别出生于1946年和1958年的全国性队列人群的成人肺功能,分析其与出生体重、出生后生长情况及早期空气污染暴露之间的关系。
研究对象为1946年3月某一周以及1958年出生于英格兰、苏格兰和威尔士且从童年期追踪至成年期的人群。
对出生于1946年的研究对象(n = 2167)在43岁时、出生于1958年的研究对象(n = 5947)在44 - 45岁时测量其1秒用力呼气量(FEV(1))和用力肺活量(FVC)。肺量计指标根据性别、成人站立身高、吸烟史以及童年期社会经济地位进行校正,并针对出生体重、生长模式及出生地区进行分析,出生地区分为国内燃煤烟雾污染暴露程度不同的四组。
在每个队列中,FEV(1)和FVC均与出生体重及相对坐高呈正相关,且独立于成人身高。合并两个队列的结果,出生体重每增加1个标准差,相互校正后的FEV(1)增加量为30 ml(95%可信区间16至45),相对坐高每增加1个标准差,FEV(1)增加量为19 ml(95%可信区间5至33)。7岁时达到的成人身高比例以及早期空气污染暴露与成人肺功能无关。
证实出生体重和躯干大小对肺功能有微小但显著的影响,但出生前和出生后生长差异以及童年期空气污染暴露差异均不太可能解释1946年和1958年出生的英国成年人在肺量计表现上的差异。