Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia.
Respirology. 2021 Nov;26(11):1060-1066. doi: 10.1111/resp.14117. Epub 2021 Aug 2.
The link between respiratory and vascular health is well documented in adult populations. Impaired lung function is consistently associated with thicker arteries and higher incidence of cardiovascular disease. However, there are limited data on this relationship in young children and the studies that exist have focussed on populations at high risk of cardiorespiratory morbidity. We determined if an association exists between respiratory and cardiovascular function in young children and, if so, whether it is confounded by known cardiorespiratory risk factors.
Respiratory and vascular data from a prospective cohort study established to evaluate the health implications 3 years after coal mine fire smoke exposure in children aged 3-5 years were used. Respiratory function was measured using the forced oscillation technique and included resistance at 5 Hz (R ), reactance at 5 Hz (X ) and area under the reactance curve (AX). Vascular health was measured by carotid intima-media thickness (ultrasound) and pulse wave velocity (arterial tonometry). Regression analyses were used to examine the relationship between the respiratory Z-scores and cardiovascular measures. Subsequent analyses were adjusted for potential confounding by maternal smoking during pregnancy, maternal education and exposure to fine particulate matter <2.5 μm in aerodynamic diameter (PM ).
Peripheral lung function (X and AX), but not respiratory system resistance (R ), was associated with vascular function. Adjustment for maternal smoking, maternal education and early life exposure to PM had minimal effect on these associations.
These observations suggest that peripheral lung stiffness is associated with vascular stiffness and that this relationship is established early in life.
呼吸系统和血管系统健康之间的联系在成年人群中已有充分的记录。肺功能受损与动脉壁增厚和心血管疾病发生率升高密切相关。然而,关于这一关系在幼儿中的数据有限,并且现有的研究集中在心肺发病率高的人群上。我们确定了在幼儿中是否存在呼吸和心血管功能之间的关联,如果存在,它是否受到已知的心肺危险因素的影响。
使用前瞻性队列研究的数据,该研究旨在评估 3-5 岁儿童在煤矿火灾烟雾暴露 3 年后的健康影响。使用强迫振荡技术测量呼吸功能,包括 5Hz 时的阻力(R)、5Hz 时的电抗(X)和电抗曲线下面积(AX)。血管健康通过颈动脉内膜中层厚度(超声)和脉搏波速度(动脉张力测定)进行测量。回归分析用于检查呼吸 Z 分数与心血管测量值之间的关系。随后的分析调整了母亲怀孕期间吸烟、母亲教育和暴露于空气动力学直径<2.5μm 的细颗粒物(PM)等潜在混杂因素。
外周肺功能(X 和 AX),而不是呼吸系统阻力(R),与血管功能有关。调整母亲吸烟、母亲教育和早期生活中 PM 的暴露对这些关联的影响很小。
这些观察结果表明,外周肺僵硬度与血管僵硬度有关,这种关系在生命早期就已建立。