Abstract
Background: Rapid weight gain during infancy increases childhood asthma risk, which might be related to impaired lung function. Objective: This study investigated associations between peak weight velocity (PWV) during the first two years of life and spirometric lung function indices at 15 years of age. Methods: Data from 1842 children participating in the GINIplus German birth cohort who underwent spirometry at age 15 were analysed. PWV was calculated from weight measurements obtained between birth and two years of age. Generalised additive models were fitted after adjustment for potential confounding factors (birth weight, height and age at lung function testing). Results are presented per interquartile range increase in PWV. Results: PWV was negatively associated with pre-bronchodilation flow rates after extensive adjustment for potential confounders including asthma: forced expiratory flow at 50% of forced vital capacity (FEF 50 ) decreased by 129ml/s (95% CI=[-211;-46]), FEF 75 by 71ml/s [-130;-12] and FEF 25-75 by 103ml/s [-176;-30]. FEV 1 /FVC was also negatively associated with PWV (-0.691% [-1.207;-0.174]) whereas forced expiratory volume in 1s (FEV 1 ) and forced vital capacity (FVC) were not. Similar results were found for measurements post-bronchodilation. Conclusion: Early life weight gain was negatively associated with flow indices in adolescence, suggesting structural changes in peripheral lungs.
Highlights
Many chronic diseases have their origin early in life (“concept of early programming”) [1,2].Environmental and nutritional factors resulting in a rapid weight gain early in life might increase the risk of being overweight or obese later on [3,4]
FEV1/FVC was negatively associated with peak weight velocity (PWV) (-0.691% [-1.207;-0.174]) whereas forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) were not
Early life weight gain was negatively associated with flow indices in adolescence, suggesting structural changes in peripheral lungs
Summary
Many chronic diseases have their origin early in life (“concept of early programming”) [1,2].Environmental and nutritional factors resulting in a rapid weight gain early in life might increase the risk of being overweight or obese later on [3,4]. During the first two years of life were at an increased risk of asthma up to the age of 6 years compared to children with a normative or persistent gain in BMI during the first 6 years of life [6] Potential mechanisms regulating these associations might be a reduced lung and breathing volume as well as changes in hormones, such as leptin and adiponectin, which have pro- and anti-inflammatory effects [9]. A reduced lung volume is associated with a lower birth weight and results in poorer lung function later in life [10,11,12] and newborns with a lower birth weight tend to have a higher weight gain after birth This association might be explained by adjustment mechanisms during the foetal period and early infancy, which are reactions to adverse factors (“developmental plasticity hypothesis”) [13,14]. During the first two years of life and spirometric lung function indices at 15 years of age
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