Wilhelmina Children's Hospital, University Medical Center Utrecht, Dept of Paediatric Pulmonology, Room KH.01.419.0, PO Box 85090, 3508 AB Utrecht, The Netherlands.
Eur Respir J. 2012 Feb;39(2):403-10. doi: 10.1183/09031936.00188310. Epub 2011 Aug 18.
The aim of our study was to investigate the association between rapid weight gain in the first 3 months of life and the prevalence of wheeze in the first years of life and lung function at 5 yrs of age. The infants selected were participating in an ongoing birth cohort. Information on growth and respiratory symptoms was collected during the first year of life, and on primary care consultations during total follow-up. Forced expiratory volume in 1 s (FEV(1)) and forced expiratory flow at 25-75% of forced vital capacity (FEF(25-75%)) were measured at 5 yrs of age. Information on growth and respiratory symptoms was obtained for 1,431 infants, out of whom 235 children had already had 5 yrs of follow-up. Every one-point z-score increase in weight gain resulted in a 37% increase in days with wheeze (incidence rate ratio 1.37, 95% CI 1.27-1.47; p<0.001) and in associated consultations by 16% (incidence rate ratio 1.16, 95% CI 1.01-1.34; p=0.04). Children with rapid weight gain reported significantly more physician-diagnosed asthma. FEV(1) and FEF(25-75%) were reduced by 34 mL (adjusted regression coefficient -0.034, 95% CI -0.056- -0.013; p=0.002) and 82 mL (adjusted regression coefficient -0.082, 95% CI -0.140- -0.024; p=0.006) per every one-point z-score increase in weight gain, respectively. These associations were independent of birthweight. Rapid early weight gain is a risk factor for clinically relevant wheezing illnesses in the first years of life and lower lung function in childhood.
我们的研究目的是探讨生命最初 3 个月内体重快速增加与生命最初几年喘息的患病率以及 5 岁时肺功能之间的关系。所选择的婴儿参与了正在进行的出生队列研究。在生命的第一年收集了有关生长和呼吸症状的信息，并在整个随访期间收集了初级保健咨询信息。在 5 岁时测量了 1 秒用力呼气量（FEV1）和 25-75%用力肺活量时的用力呼出流量（FEF25-75%）。共有 1431 名婴儿提供了有关生长和呼吸症状的信息，其中 235 名儿童已经随访了 5 年。体重增加每增加一个 z 评分，喘息天数增加 37%（发病率比 1.37，95%CI 1.27-1.47；p<0.001），相关咨询增加 16%（发病率比 1.16，95%CI 1.01-1.34；p=0.04）。体重快速增加的儿童报告的哮喘医生诊断率显著更高。FEV1 和 FEF25-75%分别降低了 34 mL（调整后的回归系数-0.034，95%CI-0.056- -0.013；p=0.002）和 82 mL（调整后的回归系数-0.082，95%CI-0.140- -0.024；p=0.006），体重每增加一个 z 评分。这些关联独立于出生体重。快速早期体重增加是生命最初几年中临床相关喘息疾病和儿童期肺功能降低的危险因素。
