Sonnenschein-van der Voort Agnes M M, Howe Laura D, Granell Raquel, Duijts Liesbeth, Sterne Jonathan A C, Tilling Kate, Henderson A John
School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; Department of Pediatrics, Division of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.
J Allergy Clin Immunol. 2015 Jun;135(6):1435-43.e7. doi: 10.1016/j.jaci.2014.10.046. Epub 2015 Jan 8.
Low birth weight and rapid infant growth in early infancy are associated with increased risk of childhood asthma, but little is known about the role of postinfancy growth in asthmatic children.
We sought to examine the associations of children's growth patterns with asthma, bronchial responsiveness, and lung function until adolescence.
Individual growth trajectories from birth until 10 years of age were estimated by using linear spline multilevel models for 9723 children participating in a population-based prospective cohort study. Current asthma at 8, 14, and 17 years of age was based on questionnaires. Lung function and bronchial responsiveness or reversibility were measured during clinic visits at 8 and 15 years of age.
Rapid weight growth between 0 and 3 months of age was most consistently associated with increased risks of current asthma at the ages of 8 and 17 years, bronchial responsiveness at age 8 years, and bronchial reversibility at age 15 years. Rapid weight growth was associated with lung function values, with the strongest associations for weight gain between 3 and 7 years of age and higher forced vital capacity (FVC) and FEV1 values at age 15 years (0.12 [95% CI, 0.08 to 0.17] and 0.11 [95% CI, 0.07 to 0.15], z score per SD, respectively) and weight growth between 0 and 3 months of age and lower FEV1/FVC ratios at age 8 and 15 years (-0.13 [95% CI, -0.16 to -0.10] and -0.04 [95% CI, -0.07 to -0.01], z score per SD, respectively). Rapid length growth was associated with lower FVC and FVC1 values at age 15 years.
Faster weight growth in early childhood is associated with asthma and bronchial hyperresponsiveness, and faster weight growth across childhood is associated with higher FVC and FEV1 values.
低出生体重和婴儿早期快速生长与儿童哮喘风险增加相关,但婴儿期后生长在哮喘儿童中的作用鲜为人知。
我们试图研究儿童生长模式与哮喘、支气管反应性及肺功能直至青春期的关联。
通过线性样条多级模型,对参与一项基于人群的前瞻性队列研究的9723名儿童从出生至10岁的个体生长轨迹进行了估计。8岁、14岁和17岁时的当前哮喘情况基于问卷调查。在8岁和15岁的门诊就诊期间测量肺功能和支气管反应性或可逆性。
0至3个月龄时体重快速增长与8岁和17岁时当前哮喘风险增加、8岁时支气管反应性增加以及15岁时支气管可逆性增加最为一致相关。体重快速增长与肺功能值相关,3至7岁体重增加与15岁时较高的用力肺活量(FVC)和第一秒用力呼气容积(FEV1)值关联最强(分别为每标准差0.12 [95%可信区间,0.08至0.17]和0.11 [95%可信区间,0.07至0.15],z评分),0至3个月龄体重增长与8岁和15岁时较低的FEV1/FVC比值相关(分别为每标准差-0.13 [95%可信区间,-0.16至-0.10]和-0.04 [95%可信区间,-0.07至-0.01],z评分)。快速身长增长与15岁时较低的FVC和FVC1值相关。
幼儿期体重增长较快与哮喘和支气管高反应性相关,儿童期体重增长较快与较高的FVC和FEV1值相关。