Department of Preventive & Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Respirology. 2024 Oct;29(10):897-904. doi: 10.1111/resp.14732. Epub 2024 May 8.
Lung function reaches a peak/plateau in early adulthood before declining with age. Lower early adult lung function may increase the risk for chronic obstructive pulmonary disease (COPD) in mid-late adult life. Understanding the effects of multiple childhood/adolescent exposures and their potential interactions on plateau lung function would provide insights into the natural history of COPD.
Longitudinal spirometry data from 688 participants with complete data from a population-based birth cohort (original n = 1037) were used to investigate associations between a wide range of childhood/adolescent exposures and repeated measures of FEV, FVC and FEV/FVC during the early-adult plateau phase. Generalized estimating equations were used to accommodate the multiple timepoints per participant.
FEV reached a peak/plateau between ages 18 and 26 and FVC from 21 to 32 years, whereas FEV/FVC declined throughout early adulthood. Childhood asthma and airway hyperresponsiveness were associated with lower early adult FEV and FEV/FVC. Smoking by age 18 was associated with lower FEV/FVC. Higher BMI during early adulthood was associated with lower FEV and FVC and lower FEV/FVC. Physical activity during adolescence was positively associated with FEV and FEV/FVC but this was only statistically significant in men. There was no convincing evidence of interactions between exposures.
Childhood asthma and airway hyperresponsiveness are associated with lower lung function in early adulthood. Interventions targeting these may reduce the risk of COPD in mid-late adult life. Promotion of physical activity during adolescence, prevention of cigarette smoking and maintenance of a healthy body weight in early adulthood are also priorities.
肺功能在成年早期达到峰值/平台期，然后随着年龄的增长而下降。较低的成年早期肺功能可能会增加中年以后患慢性阻塞性肺疾病（COPD）的风险。了解多种儿童/青少年期暴露及其潜在相互作用对平台期肺功能的影响，将有助于深入了解 COPD 的自然史。
利用基于人群的出生队列中具有完整数据的 688 名参与者的纵向肺活量测定数据（原始 n=1037），研究了广泛的儿童/青少年期暴露与 FEV、FVC 和 FEV/FVC 在成年早期平台期的多次重复测量之间的关系。使用广义估计方程来适应每个参与者的多个时间点。
FEV 在 18 至 26 岁之间达到峰值/平台期，FVC 在 21 至 32 岁之间达到平台期，而 FEV/FVC 在整个成年早期持续下降。儿童期哮喘和气道高反应性与成年早期较低的 FEV 和 FEV/FVC 相关。18 岁以前吸烟与较低的 FEV/FVC 相关。成年早期较高的 BMI 与较低的 FEV 和 FVC 以及较低的 FEV/FVC 相关。青春期的身体活动与 FEV 和 FEV/FVC 呈正相关，但仅在男性中具有统计学意义。没有令人信服的证据表明暴露之间存在相互作用。
儿童期哮喘和气道高反应性与成年早期较低的肺功能相关。针对这些因素的干预可能会降低中年以后患 COPD 的风险。促进青春期的身体活动、预防吸烟以及在成年早期保持健康的体重也是当务之急。
