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根据表型和性别分类的学龄期哮喘患病率与幼儿期体重指数变化的关系

Changes in body mass index during early childhood on school-age asthma prevalence classified by phenotypes and sex.

作者信息

Yabuuchi Toshihiko, Ikeda Masanori, Matsumoto Naomi, Tsuge Mitsuru, Yorifuji Takashi, Tsukahara Hirokazu

机构信息

Department of Pediatrics, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.

Department of Pediatrics, Okayama University Medical School, Okayama, Japan.

出版信息

Pediatr Int. 2025 Jan-Dec;67(1):e70090. doi: 10.1111/ped.70090.

Abstract

BACKGROUND

Few studies have explored the relationship between changes in body mass index(BMI) during early childhood and asthma prevalence divided by phenotypes and sex, and the limited results are conflicting. This study assessed the impact of BMI changes during early childhood on school-age asthma, classified by phenotypes and sex, using a nationwide longitudinal survey in Japan.

METHODS

From children born in 2001 (n = 47,015), we divided participants into BMI quartiles (Q1, Q2, Q3, and Q4) and the following BMI categories: Q1Q1 (i.e., Q1 at birth and Q1 at age 7), Q1Q4, Q4Q1, Q4Q4, and others. Asthma history from ages 7 to 8 was analyzed, with bronchial asthma (BA) further categorized as allergic asthma (AA) or nonallergic asthma (NA) based on the presence of other allergic diseases. Using logistic regression, we estimated the asthma odds ratio (OR) and 95% confidence intervals (CIs) for each BMI category.

RESULTS

Q1Q4 showed significantly higher risks of BA, AA, and NA. In boys, BA and NA risks were significantly higher in Q1Q4 (adjusted OR: 1.47 [95% CI: 1.17-1.85], at 1.56 [95% CI: 1.16-2.1]), with no significant difference in AA risk. In girls, no increased asthma risk was observed in Q1Q4, but AA risk was significantly higher in Q4Q4 (adjusted OR: 1.78 [95% CI: 1.21-2.6]).

CONCLUSION

Our results demonstrated that BMI changes during early childhood impact asthma risks, particularly that the risk of NA in boys increases with BMI changes during early childhood, and the risk of AA in girls increases with consistently high BMI.

摘要

背景

很少有研究探讨幼儿期体重指数(BMI)变化与按表型和性别划分的哮喘患病率之间的关系,而且有限的研究结果相互矛盾。本研究利用日本的一项全国性纵向调查,评估了幼儿期BMI变化对学龄期哮喘的影响,并按表型和性别进行分类。

方法

从2001年出生的儿童(n = 47,015)中,我们将参与者分为BMI四分位数(Q1、Q2、Q3和Q4)以及以下BMI类别:Q1Q1(即出生时为Q1且7岁时为Q1)、Q1Q4、Q4Q1、Q4Q4和其他类别。分析了7至8岁时的哮喘病史,支气管哮喘(BA)根据是否存在其他过敏性疾病进一步分为过敏性哮喘(AA)或非过敏性哮喘(NA)。使用逻辑回归,我们估计了每个BMI类别的哮喘比值比(OR)和95%置信区间(CI)。

结果

Q1Q4显示出患BA、AA和NA的风险显著更高。在男孩中,Q1Q4的BA和NA风险显著更高(调整后的OR:1.47 [95% CI:1.17 - 1.85],NA为1.56 [95% CI:1.16 - 2.1]),AA风险无显著差异。在女孩中, Q1Q4未观察到哮喘风险增加,但Q4Q4的AA风险显著更高(调整后的OR:1.78 [95% CI:1.21 - 2.6])。

结论

我们的结果表明,幼儿期BMI变化会影响哮喘风险,特别是男孩患NA的风险随幼儿期BMI变化而增加,女孩患AA的风险随持续高BMI而增加。

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