儿童期体重指数轨迹与哮喘表型之间的性别特异性关联。
Sex-Specific Association between Childhood BMI Trajectories and Asthma Phenotypes.
作者信息
Wadden Danny, Allwood Newhook Leigh-Anne, Twells Laurie, Farrell Jamie, Gao Zhiwei
机构信息
Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
出版信息
Int J Pediatr. 2018 Dec 2;2018:9057435. doi: 10.1155/2018/9057435. eCollection 2018.
BACKGROUND
Asthma and obesity are two common health problems in the pediatric population. Obesity is associated with several comorbidities which are of great consequence. Excess adipose tissue has been linked to asthma in a number of studies. However, little is known about childhood body mass index (BMI) trajectories and the development of asthma phenotypes.
OBJECTIVE
The current study aims to investigate the significance of BMI trajectories over childhood and the risk of asthma phenotypes.
METHODS
The current study is a prospective cohort of children aged 0-2 years who were followed every two years for eight years through cycles one to five in the National Longitudinal Survey of Children and Youths (NLSCY). Statistical analysis: a latent class growth modelling (LCGM) method was used to identify BMI trajectory patterns from cycles one to five. Multiple imputation (number of imputations=5) was carried out to impute children with missing values on height or weight information. Sampling weights and 1,000 bootstrap weights were used in SAS to examine the association between BMI trajectory and asthma phenotypes (persistent or transient asthma) in a multivariate analysis.
RESULTS
The study consisted of 571,790 males and 549,230 females. Among them, 46% of children showed an increasing trajectory in terms of change in BMI percentile during childhood, followed by the stable-trajectory group (41%) and decreasing-trajectory group (13%). After controlling for confounding factors, females in the increasing BMI trajectory group were four times more likely to be associated with persistent asthma (OR = 4.09; 95% CI:1.04-16.15; p = 0.0442) than females in the stable BMI trajectory group. No such relationship was found in males. The BMI trajectory was not significantly associated with risk of transient asthma for either sex.
CONCLUSION
We report a female-specific association between increasing adiposity, measured by BMI, and persistent asthma.
背景
哮喘和肥胖是儿科人群中两个常见的健康问题。肥胖与多种具有重大影响的合并症相关。在多项研究中，过多的脂肪组织已与哮喘相关联。然而，关于儿童体重指数（BMI）轨迹和哮喘表型的发展知之甚少。
目的
本研究旨在调查儿童期BMI轨迹的意义以及哮喘表型的风险。
方法
本研究是一项对0至2岁儿童的前瞻性队列研究，通过《儿童和青少年国家纵向调查》（NLSCY）的第一至第五轮，每两年对他们进行为期八年的随访。统计分析：采用潜在类别增长模型（LCGM）方法从第一轮至第五轮中识别BMI轨迹模式。对身高或体重信息有缺失值的儿童进行多重填补（填补次数 = 5）。在SAS中使用抽样权重和1000个自助权重，在多变量分析中检验BMI轨迹与哮喘表型（持续性或短暂性哮喘）之间的关联。
结果
该研究包括571,790名男性和549,230名女性。其中，46%的儿童在儿童期BMI百分位数变化方面呈现上升轨迹，其次是稳定轨迹组（41%）和下降轨迹组（13%）。在控制混杂因素后，BMI上升轨迹组中的女性与稳定BMI轨迹组中的女性相比，患持续性哮喘的可能性高出四倍（OR = 4.09；95% CI：1.04 - 16.15；p = 0.0442）。在男性中未发现这种关系。BMI轨迹与任何性别的短暂性哮喘风险均无显著关联。
结论
我们报告了以BMI衡量的肥胖增加与女性持续性哮喘之间的特定关联。
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