Cardio-metabolic risk factors during childhood in relation to lung function and asthma
Sara M Mensink-Bout1,2, Susana Santos1,3, Johan C de Jongste2
1The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Insights
Childhood cardio-metabolic risk factors like blood pressure and C-reactive protein (CRP) are linked to reduced lung function, but not asthma. These findings highlight potential early life interventions for respiratory health.
Area of Science:
- Pediatric Health
- Cardiology
- Pulmonology
- Metabolic Health
Background:
- Cardio-metabolic risk factors may impact respiratory health in children, but this association is not well understood.
- Investigating these links is crucial for understanding childhood respiratory conditions.
Purpose of the Study:
- To examine the longitudinal associations between cardio-metabolic risk factors and lung function and asthma in school-aged children.
- To determine if body mass index (BMI) mediates these associations.
Main Methods:
- A population-based cohort study of 4988 children was conducted.
- Cardio-metabolic risk factors (blood pressure, cholesterol, triglycerides, insulin, CRP) were measured at ages 6 and 10.
- Lung function (spirometry) and asthma were assessed at age 10.
Main Results:
- Higher diastolic blood pressure at age 6 was associated with increased forced vital capacity (FVC) at age 10.
- Elevated C-reactive protein (CRP) concentrations at both ages 6 and 10 were linked to lower FVC.
- No consistent associations were found for other risk factors with lung function or asthma.
Conclusions:
- Childhood blood pressure and CRP are associated with lung function, but not asthma.
- Lipids and insulin did not show significant associations with respiratory outcomes.
- Further research is needed to understand the mechanisms and long-term implications.
Background:
Cardio-metabolic risk factors might have an adverse effect on respiratory outcomes, but associations in children are unknown. We aimed to study the longitudinal associations of cardio-metabolic risk factors with lung function and asthma at school age. We also examined whether any association was explained by child's body mass index (BMI).
Methods:
In a population-based cohort study among 4988 children, cardio-metabolic risk factors were measured at 6 and 10 years and included blood pressure, cholesterol, triglycerides, insulin, and C-reactive protein (CRP) concentrations. At age 10 years, lung function was measured by spirometry and current physician-diagnosed asthma was assessed by questionnaire.
Results:
After adjustment for confounders, child's BMI, and multiple testing, we observed that a higher diastolic blood pressure at the age of 6 years was associated with a higher forced vital capacity (FVC) at the age of 10 years (Z-score difference (95% CI): 0.05 (0.01, 0.08), per SDS increase in diastolic blood pressure). Also, child's CRP concentrations above the 75th percentile at both ages 6 and 10 years were related to a lower FVC as compared to CRP concentrations below the 75th percentile at both ages (Z-score difference (95% CI) -0.21 (-0.36, -0.06)). No consistent associations of other cardio-metabolic risk factors with respiratory outcomes were observed.
Conclusion:
Blood pressure and CRP, but not lipids and insulin, were associated with lower lung function but not with asthma. The underlying mechanisms and long-term effects of these associations require further investigation.
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