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Published on: August 7, 2017
Infant body mass index trajectories and asthma and lung function
Gulshan Bano Ali1, Dinh Son Bui1, Caroline Jane Lodge1
1Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Insights
Early childhood body mass index (BMI) trajectories impact adolescent asthma and lung function. Specific patterns like rapid weight gain or persistently high BMI increase asthma risk, while low BMI is linked to restrictive lung function.
Area of Science:
- Pediatric Respiratory Health
- Growth and Development Studies
- Epidemiology
Background:
- The relationship between early body mass index (BMI) changes and adolescent respiratory health, including asthma and lung function, is not fully understood.
- Limited prospective research exists on the critical window of lung growth during infancy.
Purpose of the Study:
- To examine the association between BMI trajectories in the first two years of life and the development of asthma and lung function in adolescence.
- To identify specific infant BMI patterns linked to respiratory outcomes in later life.
Main Methods:
- Utilized anthropometric data from 620 infants in the Melbourne Atopy Cohort Study, with measurements up to 18 times in the first 24 months.
- Applied group-based trajectory modeling to define BMI trajectories and analyzed associations with spirometry, fractional exhaled nitric oxide, and asthma status at ages 12-18 years using regression models.
Main Results:
- Identified five distinct BMI trajectories. Children with 'early-low and catch-up' or 'persistently high' BMI trajectories showed increased odds of asthma at age 18.
- These trajectories were also associated with reduced FEV1/FVC ratio and elevated fractional exhaled nitric oxide. A 'persistently low' BMI trajectory correlated with reduced FEV1 and FVC values.
Conclusions:
- Specific infant BMI trajectories, including early catch-up growth and persistently high BMI, are linked to asthma and obstructive lung patterns in adolescence.
- Persistently low early BMI is associated with restrictive lung function. Maintaining normal growth patterns may improve adolescent respiratory health.
Background:
The impact of early rapid increase in body mass index (BMI) on asthma risk and subsequent lung function remains contentious, with limited prospective studies during a critical window for lung growth.
Objective:
Our aim was to investigate the associations between BMI trajectories in the first 2 years of life and adolescent asthma and lung function.
Methods:
Anthropometric data on 620 infants from the Melbourne Atopy Cohort Study were collected up to 18 times in the first 24 months of the study. BMI trajectories were developed by using group-based trajectory modeling. Associations between these trajectories and spirometry, fractional exhaled nitric oxide level, and current asthma status at 12 and/or 18 years of age were modeled by using multiple linear and logistic regression.
Results:
A total of 5 BMI trajectories were identified. Compared with those children with the "average" trajectory, the children belonging to the "early-low and catch-up" and "persistently high" BMI trajectories were at higher risk of asthma at the age of 18 years (odds ratios = 2.2 [95% CI = 1.0-4.8] and 2.4 [95% CI = 1.1-5.3], respectively). These trajectories were also associated with a lower ratio of FEV1 to forced vital capacity and a higher fractional exhaled nitric oxide levels at age 18 years. In addition, children belonging to the persistently low trajectory had lower FEV1 (β = -183.9 mL [95% CI = -340.9 to -26.9]) and forced vital capacity (β = -207.8 mL [95% CI = -393.6 to -22.0]) values at the age of 18 years.
Conclusion:
In this cohort, the early-low and catch-up and persistently high trajectories were associated with asthma and obstructive lung function pattern in adolescence. Having a persistently low BMI at an early age was associated with a restrictive pattern. Thus, maintenance of normal growth patterns may lead to improved adolescent respiratory health.
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