van Abeelen Annet F M, Elias Sjoerd G, de Jong Pim A, Grobbee Diederick E, Bossuyt Patrick M M, van der Schouw Yvonne T, Roseboom Tessa J, Uiterwaal Cuno S P M
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands ; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
PLoS One. 2013 Dec 23;8(12):e82636. doi: 10.1371/journal.pone.0082636. eCollection 2013.
Undernutrition during critical periods of growth and development may permanently affect lung physiology and function.
To investigate whether acute undernutrition in childhood or young adulthood increases the risk of later hospitalization for obstructive airways disease, chronic obstructive pulmonary disease (COPD), or asthma.
We studied 7,841 women from Prospect-EPIC who experienced the 1944-45 Dutch famine between ages 0 and 21. Pulmonary outcomes were measured by registered hospital admissions and exposure-blinded computed tomography (CT) in a subgroup of 295 women. With Cox proportional hazard regression we explored effects of famine exposure on risk of hospitalization for obstructive airways disease, COPD, and asthma. With logistic regression we explored effects of famine on risk of CT evidence of pulmonary disease.
Risks of hospitalization for obstructive airways disease, copd, and asthma were increased after moderate famine exposure, and significantly increased after severe famine exposure: hazard ratios for obstructive airways disease were 1.31 (95% CI: 0.97 to 1.77) and 1.57 (95% CI: 1.10 to 2.23) respectively. Associations between famine exposure and hospitalization for COPD were stronger in ever-smokers than in never-smokers.
Acute undernutrition in childhood or young adulthood is associated with an increased risk of later COPD and asthma hospitalization, possibly through increased sensitivity for tobacco smoke.
生长发育关键期的营养不良可能会永久性地影响肺部生理和功能。
调查儿童期或青年期的急性营养不良是否会增加日后因阻塞性气道疾病、慢性阻塞性肺疾病（COPD）或哮喘住院的风险。
我们研究了来自“展望-欧洲癌症与营养前瞻性调查（Prospect-EPIC）”的7841名女性，她们在0至21岁之间经历了1944 - 1945年的荷兰饥荒。在295名女性亚组中，通过登记的住院情况和盲法计算机断层扫描（CT）测量肺部结局。我们使用Cox比例风险回归探讨饥荒暴露对阻塞性气道疾病、COPD和哮喘住院风险的影响。使用逻辑回归探讨饥荒对肺部疾病CT证据风险的影响。
中度饥荒暴露后，阻塞性气道疾病、COPD和哮喘的住院风险增加，重度饥荒暴露后显著增加：阻塞性气道疾病的风险比分别为1.31（95%置信区间：0.97至1.77）和1.57（95%置信区间：1.10至2.23）。曾经吸烟者中，饥荒暴露与COPD住院之间的关联比从不吸烟者更强。
儿童期或青年期的急性营养不良与日后COPD和哮喘住院风险增加有关，可能是通过对烟草烟雾的敏感性增加所致。
