Bekkers Marga B, Wijga Alet H, Gehring Ulrike, Koppelman Gerard H, de Jongste Johan C, Smit Henriette A, Brunekreef Bert
Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
BMC Pulm Med. 2015 Apr 22;15:39. doi: 10.1186/s12890-015-0032-0.
In adults, overweight is associated with reduced lung function, in children evidence on this association is conflicting. We examined the association of body mass index (BMI) and waist circumference (WC) at age 12, and of persistently (at ages 8 and 12 years) high BMI and large WC, with forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) at age 12.
Height, weight, WC and FVC and FEV1 were measured during a medical examination in 1288 12-year-olds participating in the PIAMA birth cohort study. 1090 children also had BMI and WC measured at age 8. The associations between BMI and WC and FVC, FEV1, and FEV1/FVC ratio were studied using local and linear regression analyses, separately for girls and boys. The regression models were adjusted for age, height, and pubertal development and maternal educational level.
High BMI and large WC (sd-score >90th percentile) were associated with higher FVC; in girls these associations were statistically significant (4.6% (95% CI: 1.5, 7.9) and 3.6% (95% CI: 0.6, 6.8) respectively in adjusted models). Similar associations were observed for persistently high BMI or large WC: girls with a high BMI or large WC at both 8 and 12 years had statistically significantly higher FVC at age 12 years (BMI: 4.9% (95% CI 0.9, 9.1), WC: 5.0% (95% CI 0.7, 9.6)) than girls with normal BMI or WC at both ages. No statistically significant associations were observed between (persistently) high BMI or large WC and FEV1. The FEV1/FVC ratio was statistically significantly lower in children with a high BMI or large WC than in children with a normal BMI or WC. Girls and boys with a persistently high BMI or large WC status had statistically significantly lower FEV1/FVC ratios.
At 12 years of age, a persistently high BMI or large WC is not yet associated with lower FVC and FEV1, suggesting that this association, that is commonly observed in adults, develops at a later age.
在成年人中,超重与肺功能下降有关,但在儿童中,关于这种关联的证据存在矛盾。我们研究了12岁时的体重指数(BMI)和腰围(WC),以及持续(8岁和12岁时)高BMI和大腰围与12岁时用力肺活量(FVC)和1秒用力呼气量(FEV1)之间的关联。
在一项医学检查中,对参与PIAMA出生队列研究的1288名12岁儿童测量了身高、体重、腰围、FVC和FEV1。1090名儿童在8岁时也测量了BMI和腰围。分别对女孩和男孩使用局部和线性回归分析研究BMI、腰围与FVC、FEV1以及FEV1/FVC比值之间的关联。回归模型对年龄、身高、青春期发育和母亲教育水平进行了校正。
高BMI和大腰围(标准差评分>第90百分位数)与较高的FVC相关;在女孩中,这些关联具有统计学意义(校正模型中分别为4.6%(95%CI:1.5,7.9)和3.6%(95%CI:0.6,6.8))。对于持续高BMI或大腰围也观察到类似的关联:在8岁和12岁时BMI高或腰围大的女孩在12岁时FVC统计学上显著更高(BMI:4.9%(95%CI 0.9,9.1),腰围:5.0%(95%CI 0.7,9.6)),高于在两个年龄段BMI或腰围正常的女孩。在(持续)高BMI或大腰围与FEV1之间未观察到统计学上显著的关联。BMI高或腰围大的儿童的FEV1/FVC比值在统计学上显著低于BMI或腰围正常的儿童。持续BMI高或腰围大的女孩和男孩的FEV1/FVC比值在统计学上显著更低。
在12岁时,持续高BMI或大腰围尚未与较低的FVC和FEV1相关,这表明在成年人中常见的这种关联在较晚年龄才出现。