Baumann Sophie, Godtfredsen Nina Skavlan, Lange Peter, Pisinger Charlotta
Research Centre for Prevention and Health, Building 84/85, Glostrup Hospital, Ndr. Ringvej 57, DK-2600 Glostrup, Denmark; Institute of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, DE-17475 Greifswald, Germany.
Department of Respiratory Medicine, Hvidovre University Hospital, Hvidovre, Denmark.
Respir Med. 2015 Oct;109(10):1293-9. doi: 10.1016/j.rmed.2015.08.011. Epub 2015 Aug 19.
Previous studies have reported an association between low birth weight and low adult lung function, but findings have not been consistent. The aim of this study was to investigate whether birth weight is associated with both the level and the decline in adult lung function in general population.
The Danish Inter99 study is a population-based intervention study in adults aged 30-60 years, providing information on birth weight and lung function on 4428 participants. Of these, 2931 participants performed spirometry at baseline and at five-year follow-up. Multiple linear regression models were used to examine the association between birth weight and forced expiratory volume in first second (FEV1) and forced vital capacity (FVC) and age-related decline in these variables. Analyses were conducted stepwise including sex, age, adult height, abdominal circumference, birth height, mother's age at birth, parity, prematurity, multiple pregnancy, socioeconomic and lifestyle factors and lung symptoms as covariates.
Birth weight was positively associated with spirometric variables. For a 1 kg increase in birth weight, FEV1 increased by 86 ml (CI95%: 34-139) and FVC by 88 ml (CI95%: 27-148). No significant trend was found with regard to the FEV1/FVC ratio. In longitudinal analyses, there was a 0.2% (CI95%: 0.04-0.3) lower decline in FEV1/FVC ratio per year for every 1 kg increase in birth weight, whereas we found no significant association between birth weight and decline in FEV1 and FVC.
Low birth weight was significantly associated with lower adult FEV1 and FVC but not with the decline in these variables during a 5-year observation. Although FEV1/FVC ratio was not related to birth weight, persons with low birth weight experienced a steeper decline on this index. In general, the magnitude of the association between birth weight and adult lung function was modest.
既往研究报道了低出生体重与成人肺功能低下之间的关联，但研究结果并不一致。本研究的目的是调查出生体重是否与普通人群的成人肺功能水平及下降情况相关。
丹麦Inter99研究是一项针对30至60岁成年人的基于人群的干预研究，提供了4428名参与者的出生体重和肺功能信息。其中，2931名参与者在基线和五年随访时进行了肺活量测定。采用多重线性回归模型来检验出生体重与第一秒用力呼气量（FEV1）、用力肺活量（FVC）以及这些变量的年龄相关下降之间的关联。分析逐步进行，纳入性别、年龄、成人身高、腹围、出生身高、母亲生育年龄、产次、早产、多胎妊娠、社会经济和生活方式因素以及肺部症状作为协变量。
出生体重与肺活量测定变量呈正相关。出生体重每增加1千克，FEV1增加86毫升（95%CI：34 - 139），FVC增加88毫升（95%CI：27 - 148）。未发现FEV1/FVC比值有显著趋势。在纵向分析中，出生体重每增加1千克，FEV1/FVC比值每年下降幅度降低0.2%（95%CI：0.04 - 0.3），而我们未发现出生体重与FEV1和FVC下降之间存在显著关联。
低出生体重与成人较低的FEV1和FVC显著相关，但与5年观察期内这些变量的下降无关。尽管FEV1/FVC比值与出生体重无关，但低出生体重者该指标下降更为明显。总体而言，出生体重与成人肺功能之间的关联程度适中。
