Lung function trajectories from school age to adulthood and their relationship with markers of cardiovascular disease risk
Lung function trajectories from school age to adulthood and their relationship with markers of cardiovascular disease risk
Rationale: lung function in early adulthood is associated with subsequent adverse health outcomes.
Objectives: to ascertain whether stable and reproducible lung function trajectories can be derived in different populations and investigate their association with objective measures of cardiovascular structure and function.
Methods: using latent profile modelling, we studied three population-based birth cohorts with repeat spirometry data from childhood into early adulthood to identify trajectories of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC). We used multinomial logistic regression models to investigate early-life predictors of the derived trajectories. We then ascertained the extent of the association between the derived FEV1/FVC trajectories and blood pressure and echocardiographic markers of increased cardiovascular risk and stroke in ~3200 participants at age 24 years in one of our cohorts.
Results: we identified four FEV1/FVC trajectories with strikingly similar latent profiles across cohorts (pooled N=6377): above average (49.5%); average (38.3%); below average (10.6%); and persistently low (1.7%). Male sex, wheeze, asthma diagnosis/medication and allergic sensitisation were associated with trajectories with diminished lung function in all cohorts. We found evidence of an increase in cardiovascular risk markers ascertained by echocardiography (including left ventricular mass indexed to height and carotid intima-media thickness) with decreasing FEV1/FVC (with p values for the mean crude effects per-trajectory ranging from 0.10 to p<0.001). In this analysis, we considered trajectories as a pseudo-continuous variable; we confirmed the assumption of linearity in all the regression models.
Conclusions: childhood lung function trajectories may serve as predictors in the development of not only future lung disease, but also the cardiovascular disease and multimorbidity in adulthood.
Respiratory Measurement
Granell, Raquel
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Haider, Sadia
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Deliu, Matea
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Ullah, Anhar
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Mahmoud, Osama
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Fontanella, Sara
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Lowe, Lesley
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Simpson, Angela
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Dodd, James William
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Arshad, Seyed Hasan
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Murray, Clare S.
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Roberts, Graham
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Hughes, Alun
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Park, Chloe
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Holloway, John W.
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Custovic, Adnan
17d8d092-73b8-44fb-bf48-5cea7b29e3fc
on behalf of STELAR/UNICORN Investigators
16 July 2024
Granell, Raquel
06e9e006-3754-4cc9-b3fc-42024bd05123
Haider, Sadia
ed3296e0-288d-49b1-befb-fe4545a7278e
Deliu, Matea
4e4946b5-8fd6-417f-bfa9-6d07292ccc1d
Ullah, Anhar
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Mahmoud, Osama
cea428a7-081f-4a76-aabe-8ff1cf558ebc
Fontanella, Sara
6c29b69f-edd6-4414-a8fd-c47241976aa5
Lowe, Lesley
57e2168b-e46e-4f76-bd55-12729ba740be
Simpson, Angela
5591f945-0ead-46a3-a866-b7bea84a2a83
Dodd, James William
c94fb3da-f3e8-46a0-b1c3-0f928cbd5551
Arshad, Seyed Hasan
917e246d-2e60-472f-8d30-94b01ef28958
Murray, Clare S.
aca69df6-149c-401c-842f-5b2d8042edf1
Roberts, Graham
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Hughes, Alun
a8b5ade6-b7f5-450d-a56b-5bd5eb06ff4e
Park, Chloe
4039009f-3842-4704-a782-ae2b13c4551f
Holloway, John W.
4bbd77e6-c095-445d-a36b-a50a72f6fe1a
Custovic, Adnan
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Granell, Raquel, Haider, Sadia, Deliu, Matea, Ullah, Anhar, Mahmoud, Osama, Fontanella, Sara, Lowe, Lesley, Simpson, Angela, Dodd, James William, Arshad, Seyed Hasan, Murray, Clare S., Roberts, Graham, Hughes, Alun, Park, Chloe, Holloway, John W. and Custovic, Adnan
,
on behalf of STELAR/UNICORN Investigators
(2024)
Lung function trajectories from school age to adulthood and their relationship with markers of cardiovascular disease risk.
Thorax, [thorax-2023-220485].
(doi:10.1136/thorax-2023-220485).
Abstract
Rationale: lung function in early adulthood is associated with subsequent adverse health outcomes.
Objectives: to ascertain whether stable and reproducible lung function trajectories can be derived in different populations and investigate their association with objective measures of cardiovascular structure and function.
Methods: using latent profile modelling, we studied three population-based birth cohorts with repeat spirometry data from childhood into early adulthood to identify trajectories of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC). We used multinomial logistic regression models to investigate early-life predictors of the derived trajectories. We then ascertained the extent of the association between the derived FEV1/FVC trajectories and blood pressure and echocardiographic markers of increased cardiovascular risk and stroke in ~3200 participants at age 24 years in one of our cohorts.
Results: we identified four FEV1/FVC trajectories with strikingly similar latent profiles across cohorts (pooled N=6377): above average (49.5%); average (38.3%); below average (10.6%); and persistently low (1.7%). Male sex, wheeze, asthma diagnosis/medication and allergic sensitisation were associated with trajectories with diminished lung function in all cohorts. We found evidence of an increase in cardiovascular risk markers ascertained by echocardiography (including left ventricular mass indexed to height and carotid intima-media thickness) with decreasing FEV1/FVC (with p values for the mean crude effects per-trajectory ranging from 0.10 to p<0.001). In this analysis, we considered trajectories as a pseudo-continuous variable; we confirmed the assumption of linearity in all the regression models.
Conclusions: childhood lung function trajectories may serve as predictors in the development of not only future lung disease, but also the cardiovascular disease and multimorbidity in adulthood.
Text
thorax-2023-220485.full
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Accepted/In Press date: 14 April 2024
e-pub ahead of print date: 2 May 2024
Published date: 16 July 2024
Additional Information:
Publisher Copyright:
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.
Keywords:
Respiratory Measurement
Identifiers
Local EPrints ID: 490695
URI: http://eprints.soton.ac.uk/id/eprint/490695
ISSN: 0040-6376
PURE UUID: e0800695-1f90-46fb-b8ee-95f1357213e6
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Date deposited: 04 Jun 2024 16:30
Last modified: 10 Aug 2024 01:40
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Contributors
Author:
Raquel Granell
Author:
Sadia Haider
Author:
Matea Deliu
Author:
Anhar Ullah
Author:
Osama Mahmoud
Author:
Sara Fontanella
Author:
Lesley Lowe
Author:
Angela Simpson
Author:
James William Dodd
Author:
Clare S. Murray
Author:
Alun Hughes
Author:
Chloe Park
Author:
Adnan Custovic
Corporate Author: on behalf of STELAR/UNICORN Investigators
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