The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Pediatr Allergy Immunol. 2021 Jul;32(5):945-952. doi: 10.1111/pai.13509. Epub 2021 May 4.
Cardio-metabolic risk factors might have an adverse effect on respiratory outcomes, but associations in children are unknown. We aimed to study the longitudinal associations of cardio-metabolic risk factors with lung function and asthma at school age. We also examined whether any association was explained by child's body mass index (BMI).
In a population-based cohort study among 4988 children, cardio-metabolic risk factors were measured at 6 and 10 years and included blood pressure, cholesterol, triglycerides, insulin, and C-reactive protein (CRP) concentrations. At age 10 years, lung function was measured by spirometry and current physician-diagnosed asthma was assessed by questionnaire.
After adjustment for confounders, child's BMI, and multiple testing, we observed that a higher diastolic blood pressure at the age of 6 years was associated with a higher forced vital capacity (FVC) at the age of 10 years (Z-score difference (95% CI): 0.05 (0.01, 0.08), per SDS increase in diastolic blood pressure). Also, child's CRP concentrations above the 75th percentile at both ages 6 and 10 years were related to a lower FVC as compared to CRP concentrations below the 75th percentile at both ages (Z-score difference (95% CI) -0.21 (-0.36, -0.06)). No consistent associations of other cardio-metabolic risk factors with respiratory outcomes were observed.
Blood pressure and CRP, but not lipids and insulin, were associated with lower lung function but not with asthma. The underlying mechanisms and long-term effects of these associations require further investigation.
心血管代谢危险因素可能对呼吸结局产生不良影响，但儿童的相关情况尚不清楚。我们旨在研究心血管代谢危险因素与儿童期肺功能和哮喘的纵向关联。我们还研究了儿童的体重指数（BMI）是否可以解释任何关联。
在一项基于人群的队列研究中，我们对 4988 名儿童进行了 6 岁和 10 岁时的心血管代谢危险因素检测，包括血压、胆固醇、甘油三酯、胰岛素和 C 反应蛋白（CRP）浓度。在 10 岁时，通过肺活量计测量肺功能，通过问卷调查评估当前医生诊断的哮喘。
在校正混杂因素、儿童 BMI 和多重检验后，我们发现 6 岁时的舒张压较高与 10 岁时的用力肺活量较高有关（Z 分数差异（95%CI）：0.05（0.01，0.08），每增加一个 SDS 的舒张压）。此外，6 岁和 10 岁时 CRP 浓度均高于第 75 百分位数的儿童与 CRP 浓度均低于第 75 百分位数的儿童相比，用力肺活量较低（Z 分数差异（95%CI）-0.21（-0.36，-0.06））。其他心血管代谢危险因素与呼吸结局之间没有一致的关联。
血压和 CRP，但不是血脂和胰岛素，与较低的肺功能有关，但与哮喘无关。这些关联的潜在机制和长期影响需要进一步研究。
