Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana.
Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, New York, USA.
Pediatr Pulmonol. 2022 Sep;57(9):2136-2146. doi: 10.1002/ppul.26015. Epub 2022 Jun 13.
Nearly 40% of African children under 5 are stunted. We leveraged the Ghana randomized air pollution and health study (GRAPHS) cohort to examine whether poorer growth was associated with worse childhood lung function.
GRAPHS measured infant weight and length at birth and 3, 6, 9,12 months, and 4 years of age. At age 4 years, n = 567 children performed impulse oscillometry. We employed multivariable linear regression to estimate associations between birth and age 4 years anthropometry and lung function. Next, we employed latent class growth analysis (LCGA) to generate growth trajectories through age 4 years. We employed linear regression to examine associations between growth trajectory assignment and lung function.
Birth weight and age 4 weight-for-age and height-for-age z-scores were inversely associated with airway resistance (e.g., R , or total airway resistance: birth weight β = -0.90 cmH2O/L/s, 95% confidence interval [CI]: -1.64, -0.16 per 1 kg increase; and R , or large airway resistance: age 4 height-for-age β = -0.40 cmH2O/L/s, 95% CI: -0.57, -0.22 per 1 unit z-score increase). Impaired growth trajectories identified through LCGA were associated with higher airway resistance, even after adjusting for age 4 body mass index. For example, children assigned to a persistently stunted trajectory had higher R (β = 2.71 cmH2O/L/s, 95% CI: 1.07, 4.34) and R (β = 1.43 cmH2O/L/s, 95% CI: 0.51, 2.36) as compared to normal.
Children with poorer anthropometrics through to age 4 years had higher airway resistance in early childhood. These findings have implications for lifelong lung health, including pneumonia risk in childhood and reduced maximally attainable lung function in adulthood.
近 40%的 5 岁以下非洲儿童发育迟缓。我们利用加纳随机空气污染与健康研究（GRAPHS）队列来研究较差的生长情况是否与儿童肺功能更差有关。
GRAPHS 测量了婴儿出生时、3 个月、6 个月、9 个月、12 个月和 4 岁时的体重和身长。在 4 岁时，n=567 名儿童进行了脉冲振荡肺功能检测。我们采用多元线性回归来估计出生至 4 岁期间的人体测量学与肺功能之间的关联。接下来，我们采用潜在类别增长分析（LCGA）生成 4 岁前的生长轨迹。我们采用线性回归来研究生长轨迹分配与肺功能之间的关系。
出生体重和 4 岁时的体重-年龄和身高-年龄 z 评分与气道阻力（如 R ，或总气道阻力）呈负相关（例如，出生体重β=-0.90cmH2O/L/s，95%置信区间[-1.64，-0.16]，每增加 1kg；以及 R ，或大气道阻力：4 岁时的身高-年龄β=-0.40cmH2O/L/s，95%置信区间[-0.57，-0.22]，每增加 1 个单位 z 评分）。通过 LCGA 确定的生长轨迹受损与气道阻力较高有关，即使在调整了 4 岁时的体重指数后也是如此。例如，与正常生长轨迹相比，持续发育迟缓的儿童 R（β=2.71cmH2O/L/s，95%置信区间：1.07，4.34）和 R（β=1.43cmH2O/L/s，95%置信区间：0.51，2.36）更高。
4 岁前人体测量学较差的儿童在幼儿期气道阻力更高。这些发现对终身肺健康具有重要意义，包括儿童期肺炎风险和成年后最大可达肺功能降低。
