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从青少年早期到成年早期的社会经济环境与肺功能增长。

Socioeconomic circumstances and lung function growth from early adolescence to early adulthood.

机构信息

EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.

Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.

出版信息

Pediatr Res. 2021 Dec;90(6):1235-1242. doi: 10.1038/s41390-021-01380-2. Epub 2021 Feb 18.

Abstract

BACKGROUND

A reduced lung function in early adulthood is associated with respiratory and non-respiratory diseases and is a long-term predictor of mortality. This study investigated the association between early socioeconomic circumstances (SEC) and lung function growth trajectories from early adolescence until early adulthood.

METHODS

We analysed data from the EPITeen population-based study, including adolescents born in 1990. Study waves occurred at 13, 17 and 21 years of age. Information on sociodemographic, behavioural and health factors, anthropometry and spirometry was collected. Early-life SEC were assessed using maternal education and paternal occupational position. The forced expiratory volume in the first second (FEV) growth trajectories were drawn considering sex-and-height interactions over an 8-year period. Our sample included 2022 participants with complete information for the relevant variables.

RESULTS

Participants from most disadvantaged SEC presented lower FEV at early adolescence compared to high-SEC counterparts, but differences seem to diminish with height growth. The effect of paternal occupational position in lung function growth trajectories was moderated by height, thus individuals from fathers with less advantaged occupational position had lower FEV at early adolescence, but they had a faster FEV growth over time.

CONCLUSIONS

Individuals from most disadvantaged SEC presented lower lung function at early adolescence compared to high-SEC counterparts; nevertheless, a catch-up growth was observed.

IMPACT

Lower socioeconomic circumstances were previously associated with reduced lung function and a higher risk of respiratory diseases in adults. Fewer studies analysed the effects of early-life socioeconomic circumstances in lung function growth during adolescence. Disadvantaged socioeconomic circumstances were associated with lower lung function in early adolescence. However, social differences diminished over adolescence, suggesting a catch-up growth of lung function among those from lower socioeconomic circumstances. An improved understanding of the mechanism underlying lung function catch-up (or the absence of catch-up) might support interventions to narrow social inequalities in respiratory health and should be further investigated.

摘要

背景

成年早期肺功能下降与呼吸道和非呼吸道疾病有关,是长期死亡率的预测指标。本研究调查了早期社会经济环境(SEC)与青少年早期至成年早期肺功能增长轨迹之间的关系。

方法

我们分析了基于人群的 EPITeen 研究的数据,该研究包括 1990 年出生的青少年。研究波在 13、17 和 21 岁时进行。收集了社会人口统计学、行为和健康因素、人体测量学和肺活量测定数据。使用母亲的教育程度和父亲的职业地位评估早期生活 SEC。考虑到性别和身高的相互作用,在 8 年内绘制了用力呼气量(FEV)的增长轨迹。我们的样本包括 2022 名参与者,他们的相关变量信息完整。

结果

与高 SEC 对照组相比,来自最不利 SEC 的参与者在青少年早期的 FEV 较低,但随着身高的增长,差异似乎有所缩小。父亲职业地位对肺功能增长轨迹的影响受到身高的调节,因此,来自职业地位较低的父亲的个体在青少年早期的 FEV 较低,但随着时间的推移,他们的 FEV 增长更快。

结论

与高 SEC 对照组相比,来自最不利 SEC 的个体在青少年早期的肺功能较低;然而,观察到了追赶生长。

影响

较低的社会经济环境与成年人肺功能下降和呼吸道疾病风险增加有关。较少的研究分析了早期生活社会经济环境对青少年时期肺功能增长的影响。不利的社会经济环境与青少年早期的肺功能较低相关。然而,社会差异在青春期逐渐缩小,表明来自较低社会经济环境的个体的肺功能有追赶性增长。对肺功能追赶(或缺乏追赶)背后机制的深入了解可能支持缩小呼吸道健康方面的社会不平等的干预措施,应进一步研究。

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