Whitrow Melissa J, Harding Seeromanie
Medical Research Council, Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow G12 8RZ, UK.
Am J Respir Crit Care Med. 2008 Jun 1;177(11):1262-7. doi: 10.1164/rccm.200706-867OC. Epub 2008 Mar 6.
The relative contribution of body proportion and social exposures to ethnic differences in lung function has not previously been reported in the United Kingdom.
To examine ethnic differences in lung function in relation to anthropometry and social and psychosocial factors in early adolescence.
The subjects of this study were 3,924 pupils aged 11 to 13 years, of whom 80% were ethnic minorities with satisfactory lung function measures. Data were collected on economic disadvantage, psychological well-being, tobacco exposure, height, FEV(1), and FVC.
The lowest FEV(1) was observed for Black Caribbean/African children after adjusting for standing height (SH) (white boys: 2.475 L; 95% confidence interval [CI], 2.442-2.509; white girls: 2.449 L; 95% CI, 2.464-2.535]; Black Caribbean boys: -14% [95% CI, -16 to -12]; Black Caribbean girls: -13% [95% CI, -16 to -11]; Black African boys: -15% [95% CI, -17 to -13]; Black African girls: -17% [95% CI, -19 to -14]; Indian boys: -13% [95% CI, -16 to -11]; Indian girls: -11% [95% CI, -14 to -8]; Pakistani/Bangladeshi boys: -7% [95% CI, -9 to -5]; Pakistani/Bangladeshi girls: -9% [95% CI, -11 to -6]). Adjustment for upper body segment instead of SH achieved a further reduction in ethnic differences of 41 to 51% for children of Black African origin and 26 to 39% for the other groups. Overcrowding (boys) and poor psychological well-being (boys and girls) were independent correlates of FEV(1), explaining up to a further 10% of ethnic differences. Similar patterns were observed for FVC. Social exposures were also related to height components.
Differences in upper body segment explained more of the ethnic differences in lung function than SH, particularly among Black Caribbeans/African subjects. Social correlates had a smaller but significant impact. Future research needs to consider how differential development of lung capacity is compromised by the social patterning of growth trajectories.
在英国，此前尚未报道身体比例和社会暴露因素对肺功能种族差异的相对贡献。
研究青春期早期肺功能的种族差异与人体测量学、社会及心理社会因素之间的关系。
本研究的受试者为3924名11至13岁的学生，其中80%为少数民族，且肺功能测量结果良好。收集了有关经济劣势、心理健康、烟草暴露、身高、第一秒用力呼气容积（FEV₁）和用力肺活量（FVC）的数据。
在根据身高进行调整后，发现加勒比黑人/非洲裔儿童的FEV₁最低（白人男孩：2.475升；95%置信区间[CI]，2.442 - 2.509；白人女孩：2.449升；95% CI，2.464 - 2.535]；加勒比黑人男孩：-14%[95% CI，-16至-12]；加勒比黑人女孩：-13%[95% CI，-16至-11]；非洲黑人男孩：-15%[95% CI，-17至-13]；非洲黑人女孩：-17%[95% CI，-19至-14]；印度男孩：-13%[95% CI，-16至-11]；印度女孩：-11%[95% CI，-14至-8]；巴基斯坦/孟加拉裔男孩：-7%[95% CI，-9至-5]；巴基斯坦/孟加拉裔女孩：-9%[95% CI，-11至-6]）。用上身段长度而非身高进行调整后，非洲黑人儿童的种族差异进一步降低了41%至51%，其他群体则降低了26%至39%。居住拥挤（男孩）和心理健康状况不佳（男孩和女孩）是FEV₁的独立相关因素，最多可进一步解释10%的种族差异。FVC也观察到类似模式。社会暴露因素也与身高组成部分有关。
上身段长度差异比身高更能解释肺功能的种族差异，尤其是在加勒比黑人/非洲裔受试者中。社会相关因素的影响较小但具有显著性。未来的研究需要考虑生长轨迹的社会模式如何影响肺容量的差异发展。
