Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Thorax. 2016 Oct;71(10):916-22. doi: 10.1136/thoraxjnl-2014-206457. Epub 2015 Jul 16.
Findings from previous studies investigating the relationship between birth weight and adult lung function have been inconsistent, and data on birth weight and adult lung function decline are lacking. Few studies have investigated the relation between early childhood growth and adult lung function.
FEV1 and FVC were measured at ages 43 years, 53 years and 60-64 years in the 1946 British birth cohort study. Multiple linear regression models were fitted to study associations with birth weight and weight gain at age 0-2 years. Multilevel models assessed how associations changed with age, with FEV1 and FVC as repeated outcomes.
3276 and 3249 participants were included in FEV1 and FVC analyses, respectively. In women, there was a decreasing association between birth weight and FVC with age. From the multilevel model, for every 1 kg higher birth weight, FVC was higher on average by 66.3 mL (95% CI 0.5 to 132) at 43 years, but significance was lost at 53 years and 60-64 years. Similar associations were seen with FEV1, but linear change (decline) from age 43 years lost statistical significance after full adjustment. In men, associations with birth weight were null in multilevel models. Higher early life weight gain was associated with higher FEV1 at age 43 years in men and women combined but not in each sex.
Birth weight is positively associated with adult lung function in middle age, particularly in women, but the association diminishes with age, potentially due to accumulating environmental influences over the life course.
此前研究出生体重与成人肺功能之间关系的结果并不一致,且缺乏关于出生体重与成人肺功能下降关系的数据。很少有研究调查儿童早期生长与成人肺功能之间的关系。
在 1946 年英国出生队列研究中,于 43 岁、53 岁和 60-64 岁时测量 FEV1 和 FVC。使用多元线性回归模型研究出生体重与 0-2 岁时体重增加之间的关系。多层次模型评估了随着年龄的变化,FEV1 和 FVC 作为重复结果,关联如何变化。
分别有 3276 名和 3249 名参与者纳入 FEV1 和 FVC 分析。在女性中,随着年龄的增长,出生体重与 FVC 之间的关联呈下降趋势。从多层次模型来看,出生体重每增加 1kg,43 岁时 FVC 平均增加 66.3ml(95%CI 0.5 至 132),但 53 岁和 60-64 岁时无显著意义。与 FEV1 相似的关联,但从 43 岁开始,线性变化(下降)在充分调整后失去统计学意义。在男性中,多层次模型中出生体重与 FEV1 之间无关联。在男性和女性中,较高的早期生命体重增加与 43 岁时的 FEV1 较高相关,但在每个性别中均无关联。
出生体重与中年成人肺功能呈正相关,尤其是在女性中,但随着年龄的增长,这种相关性会减弱,这可能是由于一生中积累的环境影响。