Attanasi Marina, Mian Annemiek, Karramass Tarik, Duijts Liesbeth
The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Department of Pediatrics, Division of Respiratory Medicine and Allergology, Rotterdam, the Netherlands.
Pediatr Pulmonol. 2025 Aug;60(8):e71227. doi: 10.1002/ppul.71227.
We examined if sex and puberty are associated with respiratory health, and if associations were modified by ethnicity, body mass index or allergic sensitization.
Among 3418 children of a multi-ethnic population-based cohort study, medical records provided information on sex. Questionnaires provided information on pubertal stages, wheezing from birth until age 13 years and current asthma at age 13 years. Pre/early, mid, and late developmental stages of breast (girls only), genital (boys only), and pubic hair were based on Tanner stages 1-2, 3-4, and 5, respectively. Spirometry was performed at age 13 years.
Girls had a consistently lower risk of wheezing from birth until age 13 years than boys (overall OR (95% CI) 0.86 (0.74, 0.98)). Additionally, allergic girls had a lower risk of current asthma at age 13 years (0.66 (0.46, 0.94)). Only underweight and overweight/obese girls had lower and higher, respectively, FEV and FVC (Z-score difference (95% CI): -0.25 (-0.40, -0.10) and -0.23 (-0.38, -0.08); 0.26 (0.09, 0.42) and 0.24 (0.09, 0.40), respectively). Girls with a late breast stage, boys with a late genital stage, and both sexes with a late pubic hair stage had higher FEV, FVC and/or FEF, compared with those with pre/early pubertal stages at school age (range 0.18 (0.01, 0.34)-0.22 (0.03, 0.41)).
Our findings suggest a different risk of respiratory morbidity between girls and boys partly modified by BMI or allergic sensitization, not ethnicity, and that puberty has a positive effect on lung function measures in both sexes.
我们研究了性别和青春期是否与呼吸系统健康相关，以及这些关联是否会因种族、体重指数或过敏致敏而有所改变。
在一项基于多民族人群的队列研究中的3418名儿童中，医疗记录提供了性别的信息。问卷提供了青春期阶段、从出生到13岁的喘息情况以及13岁时的当前哮喘情况的信息。乳房（仅女孩）、生殖器（仅男孩）和阴毛的发育前期/早期、中期和晚期阶段分别基于坦纳分期的1 - 2期、3 - 4期和5期。在13岁时进行肺功能测定。
从出生到13岁，女孩喘息的风险始终低于男孩（总体比值比（95%可信区间）0.86（0.74，0.98））。此外，过敏女孩在13岁时患当前哮喘的风险较低（0.66（0.46，0.94））。只有体重过轻和超重/肥胖的女孩的第一秒用力呼气容积（FEV）和用力肺活量（FVC）分别较低和较高（Z评分差异（95%可信区间）：-0.25（-0.40，-0.10）和-0.23（-0.38，-0.08）；0.26（0.09，0.42）和0.24（0.09，0.40））。与学龄期处于青春期前期/早期的女孩相比，乳房发育晚期的女孩、生殖器发育晚期的男孩以及阴毛发育晚期的男女两性的FEV、FVC和/或用力呼气流量（FEF）更高（范围为0.18（0.01，0.34）-0.22（0.03，0.41））。
我们的研究结果表明，男孩和女孩之间呼吸系统发病风险不同，部分受体重指数或过敏致敏影响，而非种族，并且青春期对男女两性的肺功能指标有积极影响。
