Ho Chia-Hua, Gau Chun-Chun, Lee Wan-Fang, Fang Hsin, Lin Ching-Hua, Chu Chun-Hui, Huang Yin-Shan, Huang Yu-Wen, Huang Hsin-Yi, Tsai Hui-Ju, Yao Tsung-Chieh
Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.
World Allergy Organ J. 2022 Jul 31;15(8):100672. doi: 10.1016/j.waojou.2022.100672. eCollection 2022 Aug.
Previous studies suggest the association between early-life weight gain and asthma. It remains unclear whether early-life weight gain is associated with atopic or non-atopic asthma. This study aimed to investigate whether early-life weight gain is associated with atopic or non-atopic asthma.
Included in this study were 1343 singleton-birth children (761 boys, 57%) born between January 2010 and December 2011 participating in the Longitudinal Investigation of Global Health in Taiwanese Schoolchildren (LIGHTS) cohort were evaluated by a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and interviewed by pediatricians between July 1, 2016 and May 31, 2018 at the mean age of 6.4 years. Weight gain z-scores during the first 6, 12, and 18 months of life were classified into 4 groups: slow (below -0.67), on track (-0.67 to 0.67), rapid (0.67 to 1.28), and extremely rapid (above 1.28). The main outcomes were atopic and non-atopic asthma. Asthma was defined as having physician-diagnosed asthma and the presence of wheeze or asthma exacerbations in the last 12 months. Atopy was determined by Phadiatop Infant.
The extremely rapid weight gain group of children during the first 6, 12, and 18 months of life was significantly associated with an increased risk of non-atopic asthma (adjusted odd ratio [AOR], 2.14, 95% confidence interval [CI], 1.01-4.53 for the first 6 months; AOR, 2.86, 95% CI, 1.34-6.14 for the first 12 months; AOR, 3.26, 95% CI 1.49-7.15 for the first 18 months) compared with the on track group. No significant association was found in atopic asthma. A sex-stratified analysis revealed the association of early-life weight gain with non-atopic asthma was statistically significant only in boys (AOR, 4.24, 95% CI, 1.44-12.50).
Extremely rapid weight gain during the first 6-18 months of life was significantly associated with 2.1- to 3.3-fold increased risk of non-atopic asthma, with a more pronounced risk found in boys.
先前的研究表明生命早期体重增加与哮喘之间存在关联。目前尚不清楚生命早期体重增加与特应性或非特应性哮喘是否相关。本研究旨在调查生命早期体重增加与特应性或非特应性哮喘是否相关。
本研究纳入了1343名单胎出生儿童（761名男孩，占57%），他们于2010年1月至2011年12月出生，参与了台湾学龄儿童全球健康纵向调查（LIGHTS）队列研究。在2016年7月1日至2018年5月31日期间，由儿科医生采用改良的儿童哮喘和过敏国际研究（ISAAC）问卷对这些儿童进行评估，并进行访谈，儿童的平均年龄为6.4岁。将出生后前6个月、12个月和18个月的体重增加z评分分为4组：缓慢（低于-0.67）、正常（-0.67至0.67）、快速（0.67至1.28）和极快速（高于1.28）。主要结局为特应性和非特应性哮喘。哮喘定义为有医生诊断的哮喘且在过去12个月内有喘息或哮喘加重。特应性通过Phadiatop婴儿检测确定。
与正常组相比，在出生后前6个月、12个月和18个月体重增加极快速的儿童组与非特应性哮喘风险增加显著相关（出生后前6个月：调整后的优势比[AOR]为2.14，95%置信区间[CI]为1.01-4.53；出生后前12个月：AOR为2.86，95%CI为[1.34-6.14]；出生后前18个月：AOR为3.26，95%CI为1.49-7.15）。在特应性哮喘中未发现显著关联。按性别分层分析显示，生命早期体重增加与非特应性哮喘的关联仅在男孩中具有统计学意义（AOR为4.24，95%CI为1.44-12.50）。
出生后前6-18个月体重增加极快速与非特应性哮喘风险增加2.1至3.3倍显著相关，男孩中的风险更为明显。
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