Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet and Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
University of Barcelona, FCRB-IDIBAPS, CIBERES, Barcelona, Spain.
Lancet. 2024 Apr 13;403(10435):1494-1503. doi: 10.1016/S0140-6736(24)00016-3. Epub 2024 Mar 12.
Lung development starts in utero and continues during childhood through to adolescence, reaching its peak in early adulthood. This growth is followed by gradual decline due to physiological lung ageing. Lung-function development can be altered by several host and environmental factors during the life course. As a result, a range of lung-function trajectories exist in the population. Below average trajectories are associated with respiratory, cardiovascular, metabolic, and mental health comorbidities, as well as with premature death. This Review presents progressive research into lung-function trajectories and assists the implementation of this knowledge in clinical practice as an innovative approach to detect poor lung health early, monitor respiratory disease progression, and promote lung health. Specifically, we propose that, similar to paediatric height and weight charts used globally to monitor children's growth, lung-function charts could be used for both children and adults to monitor lung health status across the life course. To achieve this proposal, we introduce our free online Lung Function Tracker tool. Finally, we discuss challenges and opportunities for effective implementation of the trajectory concept at population level and outline an agenda for crucial research needed to support such implementation.
肺脏发育始于胎儿期，并在儿童期持续至青春期，在成年早期达到高峰。此后，由于生理肺老化，肺功能逐渐下降。在整个生命过程中，多种宿主和环境因素会影响肺功能的发育。因此，人群中存在多种肺功能轨迹。低于平均水平的轨迹与呼吸系统、心血管系统、代谢和心理健康合并症以及过早死亡有关。本综述介绍了肺功能轨迹的研究进展，并提出将该知识应用于临床实践，作为一种早期发现不良肺健康、监测呼吸道疾病进展和促进肺健康的创新方法。具体而言，我们建议，类似于全球用于监测儿童生长的儿童身高和体重图表，肺功能图表可用于儿童和成人，以监测整个生命过程中的肺健康状况。为了实现这一建议，我们引入了免费的在线肺功能追踪工具。最后，我们讨论了在人群层面有效实施轨迹概念的挑战和机遇，并概述了支持这一实施所需的关键研究议程。
