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Relation of early childhood growth and wheezing phenotypes to adult lung function
Duane L Sherrill1, Stefano Guerra, Anne L Wright
1Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA. dls3@email.arizona.edu
Insights
Rapid weight gain in early childhood (3-6 years) is linked to better adult lung function (FVC and FEV1), but only if children do not experience early wheezing illnesses.
Area of Science:
- Pediatric Respiratory Health
- Growth and Development
- Pulmonary Function Assessment
Background:
- Childhood growth patterns and birth size are linked to adult pulmonary function.
- Early life weight gain may influence long-term lung health.
- Understanding wheezing phenotypes is crucial for assessing these associations.
Purpose of the Study:
- To investigate the association between early life weight gain (birth-6 years) and adult lung function (FVC and FEV1).
- To determine if early childhood wheezing phenotypes modify this association.
Main Methods:
- Prospective birth cohort study (Tucson Children's Respiratory Study).
- Weight measured quarterly up to age 3, and at age 6.
- Pulmonary function (FVC, FEV1) assessed at ages 16 and 22.
- Longitudinal models used to analyze predictors of lung function.
Main Results:
- Positive association found between weight gain rate (3-6 years) and adult FVC at ages 16 and 22.
- This association was absent in children with early wheezing illnesses (first 3 years).
- Similar trends observed for FEV1.
Conclusions:
- The rate of weight gain between 3 and 6 years is significantly associated with adult FVC and FEV1.
- Early wheezing phenotypes modify the relationship between childhood weight gain and adult lung function.
Rationale:
Several studies have reported associations between indicators of birth size and postnatal growth rates with levels of pulmonary function achieved as adults. The objective of this study was to determine if levels and/or rates of weight gain, measured in early life (birth-6 years), are associated with FVC or FEV1 levels achieved in young adulthood and if these associations differ by early childhood wheezing phenotypes.
Methods:
We used data from participants in the Tucson Children's Respiratory Study (CRS), a prospective birth cohort study. Weight was measured quarterly up to age 3 years and again at age 6 years. Pulmonary function was assessed at ages 16 and 22. Mean weight and slope of weight growth between 3 and 6 years were estimated using standardized residuals. Longitudinal models were used to determine predictors of FVC and FEV1 at ages 16 and 22 years.
Results:
There were 127 non-Hispanic white subjects that had at least four weight measures and one or more pulmonary function measures as young adults. After adjusting for sex, height, and age, the standardized slope of weight growth (between 3 and 6 years) was positively associated with higher levels of FVC at age 16 and 22 years (P = 0.0001) among subjects who did not have preschool wheezing. However, this association was completely absent among subjects who had wheezing lower respiratory tract illnesses in the first 3 years of life. Similar trends were found for FEV1.
Conclusion:
The rate of weight gain between 3 and 6 years is significantly positively related to adult FVC and FEV1 and this association is modified by early wheezy phenotypes.
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