PDF(Pubmed)
Abstract：
BACKGROUND: Lung function in early adulthood is associated with subsequent adverse health outcomes.
OBJECTIVE: To ascertain whether stable and reproducible lung function trajectories can be derived in different populations and investigate their association with objective measures of cardiovascular structure and function.
METHODS: Using latent profile modelling, we studied three population-based birth cohorts with repeat spirometry data from childhood into early adulthood to identify trajectories of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC). We used multinomial logistic regression models to investigate early-life predictors of the derived trajectories. We then ascertained the extent of the association between the derived FEV1/FVC trajectories and blood pressure and echocardiographic markers of increased cardiovascular risk and stroke in ~3200 participants at age 24 years in one of our cohorts.
RESULTS: We identified four FEV1/FVC trajectories with strikingly similar latent profiles across cohorts (pooled N=6377): above average (49.5%); average (38.3%); below average (10.6%); and persistently low (1.7%). Male sex, wheeze, asthma diagnosis/medication and allergic sensitisation were associated with trajectories with diminished lung function in all cohorts. We found evidence of an increase in cardiovascular risk markers ascertained by echocardiography (including left ventricular mass indexed to height and carotid intima-media thickness) with decreasing FEV1/FVC (with p values for the mean crude effects per-trajectory ranging from 0.10 to p<0.001). In this analysis, we considered trajectories as a pseudo-continuous variable; we confirmed the assumption of linearity in all the regression models.
CONCLUSIONS: Childhood lung function trajectories may serve as predictors in the development of not only future lung disease, but also the cardiovascular disease and multimorbidity in adulthood.
OBJECTIVE: To ascertain whether stable and reproducible lung function trajectories can be derived in different populations and investigate their association with objective measures of cardiovascular structure and function.
METHODS: Using latent profile modelling, we studied three population-based birth cohorts with repeat spirometry data from childhood into early adulthood to identify trajectories of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC). We used multinomial logistic regression models to investigate early-life predictors of the derived trajectories. We then ascertained the extent of the association between the derived FEV1/FVC trajectories and blood pressure and echocardiographic markers of increased cardiovascular risk and stroke in ~3200 participants at age 24 years in one of our cohorts.
RESULTS: We identified four FEV1/FVC trajectories with strikingly similar latent profiles across cohorts (pooled N=6377): above average (49.5%); average (38.3%); below average (10.6%); and persistently low (1.7%). Male sex, wheeze, asthma diagnosis/medication and allergic sensitisation were associated with trajectories with diminished lung function in all cohorts. We found evidence of an increase in cardiovascular risk markers ascertained by echocardiography (including left ventricular mass indexed to height and carotid intima-media thickness) with decreasing FEV1/FVC (with p values for the mean crude effects per-trajectory ranging from 0.10 to p<0.001). In this analysis, we considered trajectories as a pseudo-continuous variable; we confirmed the assumption of linearity in all the regression models.
CONCLUSIONS: Childhood lung function trajectories may serve as predictors in the development of not only future lung disease, but also the cardiovascular disease and multimorbidity in adulthood.
摘要：
背景：成年早期的肺功能与随后的不良健康结局相关。
目的：确定是否可以在不同人群中得出稳定和可重复的肺功能轨迹，并研究其与心血管结构和功能的客观指标的关系。
方法：使用潜在轮廓建模，我们研究了3个基于人群的出生队列,从儿童到成年早期的重复肺活量测定数据,以确定1s用力呼气量(FEV1)/用力肺活量(FVC)的轨迹.我们使用多项逻辑回归模型来研究推导轨迹的早期生命预测因子。然后，在我们的一个队列中，在约3200名24岁的参与者中，我们确定了衍生的FEV1/FVC轨迹与血压和心血管风险增加和中风的超声心动图标志物之间的关联程度。
结果：我们确定了四个FEV1/FVC轨迹，在队列中具有惊人相似的潜在特征（汇总N=6377）：高于平均水平（49.5%）；平均（38.3%）；低于平均水平（10.6%）；和持续低（1.7%）。男性,喘息,在所有队列中,哮喘诊断/药物治疗和变态反应致敏均与肺功能减退的轨迹相关.我们发现有证据表明，随着FEV1/FVC的降低，超声心动图确定的心血管风险标志物（包括左心室质量与身高和颈动脉内膜中层厚度指数）增加（每个轨迹的平均粗效应的p值范围为0.10至p<0.001）。在这个分析中,我们将轨迹视为伪连续变量；我们证实了所有回归模型中的线性假设。
结论：儿童肺功能轨迹不仅可以作为未来肺部疾病发展的预测因子，还有成年期的心血管疾病和多发病。
目的：确定是否可以在不同人群中得出稳定和可重复的肺功能轨迹，并研究其与心血管结构和功能的客观指标的关系。
方法：使用潜在轮廓建模，我们研究了3个基于人群的出生队列,从儿童到成年早期的重复肺活量测定数据,以确定1s用力呼气量(FEV1)/用力肺活量(FVC)的轨迹.我们使用多项逻辑回归模型来研究推导轨迹的早期生命预测因子。然后，在我们的一个队列中，在约3200名24岁的参与者中，我们确定了衍生的FEV1/FVC轨迹与血压和心血管风险增加和中风的超声心动图标志物之间的关联程度。
结果：我们确定了四个FEV1/FVC轨迹，在队列中具有惊人相似的潜在特征（汇总N=6377）：高于平均水平（49.5%）；平均（38.3%）；低于平均水平（10.6%）；和持续低（1.7%）。男性,喘息,在所有队列中,哮喘诊断/药物治疗和变态反应致敏均与肺功能减退的轨迹相关.我们发现有证据表明，随着FEV1/FVC的降低，超声心动图确定的心血管风险标志物（包括左心室质量与身高和颈动脉内膜中层厚度指数）增加（每个轨迹的平均粗效应的p值范围为0.10至p<0.001）。在这个分析中,我们将轨迹视为伪连续变量；我们证实了所有回归模型中的线性假设。
结论：儿童肺功能轨迹不仅可以作为未来肺部疾病发展的预测因子，还有成年期的心血管疾病和多发病。
