Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Pediatrics. 2013 Jun;131(6):e1842-9. doi: 10.1542/peds.2012-3003. Epub 2013 May 27.
Age- and height-adjusted spirometric lung function of South Asian children is lower than those of white children. It is unclear whether this is purely genetic, or partly explained by the environment. In this study, we assessed whether cultural factors, socioeconomic status, intrauterine growth, environmental exposures, or a family and personal history of wheeze contribute to explaining the ethnic differences in spirometric lung function.
We studied children aged 9 to 14 years from a population-based cohort, including 1088 white children and 275 UK-born South Asians. Log-transformed spirometric data were analyzed using multiple linear regressions, adjusting for anthropometric factors. Five different additional models adjusted for (1) cultural factors, (2) indicators of socioeconomic status, (3) perinatal data reflecting intrauterine growth, (4) environmental exposures, and (5) personal and family history of wheeze.
Height- and gender-adjusted forced vital capacity (FVC) and forced expired volume in 1 second (FEV1) were lower in South Asian than white children (relative difference -11% and -9% respectively, P < .001), but PEF and FEF50 were similar (P ≥ .5). FEV1/FVC was higher in South Asians (1.8%, P < .001). These differences remained largely unchanged in all 5 alternative models.
Our study confirmed important differences in lung volumes between South Asian and white children. These were not attenuated after adjustment for cultural and socioeconomic factors and intrauterine growth, neither were they explained by differences in environmental exposures nor a personal or family history of wheeze. This suggests that differences in lung function may be mainly genetic in origin. The implication is that ethnicity-specific predicted values remain important specifically for South Asian children.
与白人儿童相比，南亚儿童的年龄和身高校正后肺功能较低。目前尚不清楚这纯粹是遗传因素，还是部分由环境因素造成的。在这项研究中，我们评估了文化因素、社会经济地位、宫内生长、环境暴露以及喘息的家族和个人史是否有助于解释肺功能的种族差异。
我们研究了来自基于人群的队列的 9 至 14 岁儿童，包括 1088 名白人儿童和 275 名英国出生的南亚人。使用多元线性回归分析对经过对数转换的肺功能数据进行分析，并调整了人体测量因素。另外五个不同的模型分别调整了（1）文化因素，（2）社会经济地位指标，（3）反映宫内生长的围产期数据，（4）环境暴露，以及（5）个人和家族喘息史。
身高和性别调整后的用力肺活量（FVC）和 1 秒用力呼气量（FEV1）在南亚儿童中均低于白人儿童（相对差异分别为-11%和-9%，P<0.001），但呼气峰流速（PEF）和 50%肺活量时的呼气流量（FEF50）相似（P≥0.5）。FEV1/FVC 在南亚人中较高（1.8%，P<0.001）。在所有 5 种替代模型中，这些差异基本保持不变。
我们的研究证实了南亚儿童和白人儿童之间在肺容量方面存在重要差异。在调整文化和社会经济因素以及宫内生长后，这些差异并没有减弱，环境暴露差异或喘息的个人或家族史也无法解释这些差异。这表明肺功能的差异主要源于遗传。这意味着特定种族的预测值对于南亚儿童仍然很重要。
