Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany.
ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003, Barcelona, Spain.
Respir Res. 2017 Jul 12;18(1):138. doi: 10.1186/s12931-017-0619-5.
Various factors may affect lung function at different stages in life. Since investigations that simultaneously consider several factors are rare, we examined the relative importance of early life, current environmental/lifestyle factors and allergic diseases on lung function in 15-year-olds.
Best subset selection was performed for linear regression models to investigate associations between 21 diverse early life events and current factors with spirometric parameters (forced vital capacity, forced expiratory volume in 1 s and maximal mid-expiratory flow (FEF)) in 1326 participants of the German GINIplus and LISAplus birth cohorts. To reduce model complexity, one model for each spirometric parameter was replicated 1000 times in random subpopulations (N = 884). Only those factors that were included in >70% of the replication models were retained in the final analysis.
A higher peak weight velocity and early lung infections were the early life events prevalently associated with airflow limitation and FEF. Current environmental/lifestyle factors at age 15 years and allergic diseases that were associated with lung function were: indoor second-hand smoke exposure, vitamin D concentration, body mass index (BMI) and asthma status. Sex and height captured the majority of the explained variance (>75%), followed by BMI (≤23.7%). The variance explained by early life events was comparatively low (median: 4.8%; range: 0.2-22.4%), but these events were consistently negatively associated with airway function.
Although the explained variance was mainly captured by well-known factors included in lung function prediction equations, our findings indicate early life and current factors that should be considered in studies on lung health among adolescents.
各种因素可能会在生命的不同阶段影响肺功能。由于很少有研究同时考虑多种因素，因此我们在 15 岁的青少年中研究了早期生活、当前环境/生活方式因素和过敏性疾病对肺功能的相对重要性。
采用最佳子集选择进行线性回归模型分析，以探讨 21 种不同的早期生活事件和当前因素与肺功能指标（用力肺活量、1 秒用力呼气量和最大中期呼气流速（FEF））之间的关联，其中包括德国 GINIplus 和 LISAplus 出生队列的 1326 名参与者。为了简化模型复杂性，针对每个肺功能指标的一个模型在随机子群体（N=884）中重复 1000 次。仅将那些包含在 >70%的重复模型中的因素保留在最终分析中。
较高的峰值体重增长率和早期肺部感染是与气流受限和 FEF 相关的主要早期生活事件。与肺功能相关的 15 岁时的当前环境/生活方式因素和过敏性疾病包括：室内二手烟暴露、维生素 D 浓度、体重指数（BMI）和哮喘状态。性别和身高占解释方差的大部分（>75%），其次是 BMI（≤23.7%）。早期生活事件的解释方差相对较低（中位数：4.8%；范围：0.2-22.4%），但这些事件与气道功能呈负相关。
尽管解释方差主要由肺功能预测方程中包含的已知因素捕获，但我们的研究结果表明，早期生活和当前因素在青少年肺部健康研究中应予以考虑。
