Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
Eur Respir J. 2022 Sep 15;60(3). doi: 10.1183/13993003.02286-2021. Print 2022 Sep.
High body mass index (BMI) trajectories from childhood to adulthood are associated with the development of some chronic diseases, but whether such trajectories influence adult asthma has not been investigated to date. Therefore, we investigated associations between BMI trajectories from childhood to middle age (5-43 years) and incidence, persistence and relapse of asthma from ages 43 to 53 years.
In the Tasmanian Longitudinal Health Study (n=4194), weight and height were recorded at eight time-points between 5 and 43 years of age. BMI trajectories were developed using group-based trajectory modelling. Associations between BMI trajectories and asthma incidence, persistence and relapse from age 43 to 53 years, bronchial hyperresponsiveness (BHR) at age 50 years, and bronchodilator responsiveness at age 53 years were modelled using multiple logistic and linear regression.
Five distinct BMI trajectories were identified: average, low, child high-decreasing, child average-increasing and high. Compared with the average trajectory, child average-increasing and high trajectories were associated with increased risk of incident asthma (OR 2.6, 95% CI 1.1-6.6 and OR 4.4, 95% CI 1.7-11.4, respectively) and BHR in middle age (OR 2.9, 95% CI 1.1-7.5 and OR 3.5, 95% CI 1.1-11.4, respectively). No associations were observed for asthma persistence or relapse.
Participants with child average-increasing and high BMI trajectories from childhood to middle age were at higher risk of incident adult asthma. Thus, encouraging individuals to maintain a normal BMI over the life course may help reduce the burden of adult asthma.
从儿童期到成年期的高体重指数（BMI）轨迹与某些慢性疾病的发展有关，但这些轨迹是否会影响成人哮喘尚未得到调查。因此，我们研究了从儿童期到中年（5-43 岁）的 BMI 轨迹与 43 至 53 岁成人哮喘的发病、持续和复发之间的关系。
在塔斯马尼亚纵向健康研究（n=4194）中，在 5 至 43 岁之间的八个时间点记录了体重和身高。使用基于群组的轨迹建模方法来开发 BMI 轨迹。使用多元逻辑回归和线性回归模型来研究 BMI 轨迹与 43 至 53 岁期间哮喘的发病、持续和复发、50 岁时的支气管高反应性（BHR）以及 53 岁时的支气管扩张剂反应之间的关系。
确定了五种不同的 BMI 轨迹：平均、低、儿童高-下降、儿童平均-增加和高。与平均轨迹相比，儿童平均增加和高轨迹与成人哮喘发病风险增加相关（OR 2.6，95%CI 1.1-6.6 和 OR 4.4，95%CI 1.7-11.4），以及中年时的 BHR（OR 2.9，95%CI 1.1-7.5 和 OR 3.5，95%CI 1.1-11.4）。哮喘持续或复发与 BMI 轨迹无关联。
从儿童期到中年期 BMI 轨迹呈儿童平均增加和高的参与者患成人哮喘的风险更高。因此，鼓励个人在整个生命过程中保持正常 BMI 可能有助于减轻成人哮喘的负担。
