Rationale Life course trajectories of lung function development and decline influence the risk for lung disease but are poorly documented. Objective To document lung function trajectories from childhood to mid-adult life. Methods We modelled forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC at ages 9, 11, 13, 15, 18, 21, 26, 32, 38 and 45 years from a population-based cohort using latent profile analysis to identify distinct subgroups of participants with similar lung function trajectories. Regression analyses were used to assess associations between the trajectories, early life factors and postbronchodilator airflow obstruction at age 45. Results Among 865 participants with ≥6 measures of lung function, we identified 10 distinct FEV1 trajectories. Most were approximately parallel except for a childhood airway hyper-responsiveness-related persistently low trajectory (3% of study population); two accelerated-decline trajectories, one of which (8%) was associated with smoking and higher adult body mass index (BMI) and a catch-up trajectory (8%). Findings for FEV1/FVC trajectories were similar. Nine trajectories were identified for FVC: most were also approximately parallel except for a higher BMI-related accelerated-decline trajectory. The three FEV1 trajectories leading to the lowest FEV1 values comprised 19% of the cohort but contributed 55% of airflow obstruction at age 45. Conclusions Lung function trajectories to mid-adult life are largely established before adolescence, with a few exceptions: a childhood airway hyper-responsiveness-related persistently low trajectory, which starts low and gets worse with age, and accelerated adult decline trajectories associated with smoking and obesity. Adverse trajectories are associated with a high risk of airflow obstruction in mid-adult life. Data are available on reasonable request. We do not have ethical approval to make the data publicly available. Deidentified data may be available to researchers on reasonable request subject to an approved research proposal.

中文翻译：

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从儿童期到中年期肺功能的不同轨迹

基本原理 肺功能发展和衰退的生命历程轨迹会影响肺部疾病的风险，但记录很少。目的 记录从童年到中年的肺功能轨迹。方法 我们根据基于人群的数据对 9、11、13、15、18、21、26、32、38 和 45 岁时的 1 秒用力呼气量 (FEV1)、用力肺活量 (FVC) 和 FEV1/FVC 进行建模。使用潜在特征分析来识别具有相似肺功能轨迹的不同参与者亚组。回归分析用于评估 45 岁时轨迹、早期生活因素和支气管扩张剂后气流阻塞之间的关联。结果 在 865 名具有 ≥ 6 项肺功能测量值的参与者中，我们确定了 10 条不同的 FEV1 轨迹。除了儿童气道高反应性相关的持续低轨迹（占研究人群的 3%）外，大多数情况大致平行；两条加速下降轨迹，其中一条 (8%) 与吸烟和较高的成人体重指数 (BMI) 相关，另一条是追赶轨迹 (8%)。FEV1/FVC 轨迹的​​结果相似。确定了用力肺活量的九个轨迹：除了较高的 BMI 相关加速下降轨迹外，大多数轨迹也大致平行。导致最低 FEV1 值的三个 FEV1 轨迹占该队列的 19%，但在 45 岁时造成了 55% 的气流阻塞。结论 到中年生活的肺功能轨迹主要在青春期之前建立，但有一些例外：儿童气道与高反应性相关的持续低轨迹，开始时较低，并随着年龄的增长而恶化，并加速与吸烟和肥胖相关的成年衰退轨迹。不良轨迹与中年时期气流阻塞的高风险相关。可根据合理要求提供数据。我们没有获得公开数据的道德批准。根据经批准的研究计划，研究人员可以根据合理请求向研究人员提供去识别化数据。