Related Experiment Video
Updated: Sep 12, 2025
Employing the Forced Oscillation Technique for the Assessment of Respiratory Mechanics in Adults
Published on: February 9, 2022
Sex and Pubertal Status in Relation to Wheezing, Asthma, and Lung Function Development in a Multi-Ethnic
Marina Attanasi1,2,3, Annemiek Mian1,2, Tarik Karramass1,2
1The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Insights
Sex and puberty influence children's respiratory health. Girls have lower wheezing risk, while puberty positively impacts lung function in both sexes, modified by body mass index and allergies.
Area of Science:
- Pediatric Respiratory Medicine
- Environmental Epidemiology
- Human Growth and Development
Background:
- Sex and pubertal development are critical factors influencing physiological changes.
- Understanding their impact on respiratory health in children is essential for targeted interventions.
- Previous research has not fully elucidated these associations across diverse populations.
Purpose of the Study:
- To investigate the association between sex and puberty with respiratory health outcomes in children.
- To determine if ethnicity, body mass index (BMI), or allergic sensitization modify these associations.
- To assess the impact of pubertal development on lung function measures.
Main Methods:
- A multi-ethnic, population-based cohort study of 3418 children.
- Data collected via medical records (sex) and questionnaires (pubertal stages, wheezing, asthma).
- Pubertal stages categorized using Tanner stages; spirometry performed at age 13.
Main Results:
- Girls exhibited a consistently lower risk of wheezing (OR 0.86) and allergic girls had lower asthma risk (OR 0.66).
- Underweight and overweight/obese girls showed lower and higher lung function (FEV1, FVC) Z-scores, respectively.
- Late pubertal development (breast, genital, pubic hair) was associated with improved lung function (FEV1, FVC, FEF75) in both sexes.
Conclusions:
- Respiratory morbidity risk differs between sexes, influenced by BMI and allergic sensitization, but not ethnicity.
- Puberty positively affects lung function measures in both boys and girls.
- Findings highlight the importance of considering sex and pubertal status in pediatric respiratory health.
Aim:
We examined if sex and puberty are associated with respiratory health, and if associations were modified by ethnicity, body mass index or allergic sensitization.
Methods:
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.
Results:
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, FEV1 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 FEV1, FVC and/or FEF75, compared with those with pre/early pubertal stages at school age (range 0.18 (0.01, 0.34)-0.22 (0.03, 0.41)).
Conclusion:
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.
Related Concept Videos
01:24Respiratory Capacities
One key metric is the Inspiratory Capacity (IC), which represents the maximum amount of air that can be inhaled with full effort. IC is calculated by summing the tidal volume and inspiratory reserve volume, typically ranging from 2.4 to 3.6 liters.
The Functional Residual Capacity (FRC) represents the air in the...
01:24Factors Affecting Respiration
01:27Physical Assessment of the Respiratory Tract II: Inspection
Chest Configuration
The chest configuration...
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
01:28Physical Assessment of the Respiratory Tract I: Health History
Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and...