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Respiratory epidemiology
Original research
Physical activity and body mass related to catch-up lung function growth in childhood: a population-based accelerated cohort study
  1. Sarah Koch1,2,3,
  2. Gabriela Prado Peralta1,2,3,4,
  3. Anne-Elie Carsin1,2,3,5,
  4. Alicia Abellan1,2,3,6,
  5. Celine Roda7,8,
  6. Maties Torrent9,
  7. Carmen Iñiguez3,10,
  8. Ferran Ballester3,11,12,
  9. Amparo Ferrero3,
  10. Carlos Zabaleta13,14,
  11. Aitana Lertxundi3,14,15,
  12. Mònica Guxens1,2,3,16,
  13. Martine Vrijheid1,2,3,
  14. Jordi Sunyer1,2,3,
  15. Maribel Casas1,2,3,
  16. Judith Garcia-Aymerich1,2,3
  1. 1Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
  2. 2Universitat Pompeu Fabra (UPF), Barcelona, Spain
  3. 3CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
  4. 4Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
  5. 5IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
  6. 6Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
  7. 7Université Paris Cité, Sorbonne Paris-Nord, INRAe, INSERM, UMR 1153-CRESS, HERA Team, Paris, France
  8. 8Faculté de Pharmacie de Paris, Université Paris Cité, Paris, France
  9. 9Area de Salut de Menorca, IB-SALUT, Mahon, Menorca, Spain
  10. 10Department of Statistics and Operations Research, Universitat de València, Burjassot, Spain
  11. 11Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I – Universitat de València, Valencia, Spain
  12. 12Nursing Department, Universitat de Valencia, Valencia, Spain
  13. 13Servicio de Pediatria del Hospital Zumarraga, Zumarraga, Spain
  14. 14Health Research Institute BioGipuzkoa, San Sebastian, Spain
  15. 15Preventive Medicine and Public Health Department, University of Basque Country, Spain
  16. 16Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
  1. Correspondence to Dr Sarah Koch, ISGlobal, Barcelona, Catalunya 08003, Spain; sarah.koch{at}isglobal.org

Abstract

Objective The existence of catch-up lung function growth and its predictors is uncertain. We aimed to identify lung function trajectories and their predictors in a population-based birth cohort.

Methods We applied group-based trajectory modelling to z-scores of forced expiratory volume in 1 second (zFEV1) and z-scores of forced vital capacity (zFVC) from 1151 children assessed at around 4, 7, 9, 10, 11, 14 and 18 years. Multinomial logistic regression models were used to test whether potential prenatal and postnatal predictors were associated with lung function trajectories.

Results We identified four lung function trajectories: a low (19% and 19% of the sample for zFEV1 and zFVC, respectively), normal (62% and 63%), and high trajectory (16% and 13%) running in parallel, and a catch-up trajectory (2% and 5%) with catch-up occurring between 4 and 10 years. Fewer child allergic diseases and higher body mass index z-score (zBMI) at 4 years were associated with the high and normal compared with the low trajectories, both for zFEV1 and zFVC. Increased children’s physical activity during early childhood and higher zBMI at 4 years were associated with the catch-up compared with the low zFEV1 trajectory (relative risk ratios: 1.59 per physical activity category (1.03–2.46) and 1.47 per zBMI (0.97–2.23), respectively). No predictors were identified for zFVC catch-up growth.

Conclusion We found three parallel-running and one catch-up zFEV1 and zFVC trajectories, and identified physical activity and body mass at 4 years as predictors of zFEV1 but not zFVC catch-up growth.

  • Exercise
  • COPD epidemiology

Data availability statement

Data may be obtained from a third party and are not publicly available. Data are not publicly available but can be obtained from a third party after acceptance of a proposal by the INMA research committee.

https://doi.org/10.1136/thorax-2022-219666

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. Data are not publicly available but can be obtained from a third party after acceptance of a proposal by the INMA research committee.

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    Footnotes

    • Twitter @gabriela___p, @judithgarciaaym

    • Contributors JGA and MC conceptualised this project and provided supervision. MT, FB, CI, AL, MG, MV, JS, MC and JG-A were responsible for the project administration, data collection and resource management. SK, AEC and JGA verified the underlying data. SK, AEC, AB, CR, MG, JS, MC, JG-A were responsible for data curation. SK, GPP, AEC, AA and JGA performed the data analyses. GPP and EAC provided support with respect to used analysis software. SK, GPP, AEC, AA, MG, MV, MC, JG-A were responsible for the data interpretation. SK and JGA wrote the original draft, and GPP, AEC, AA, CR, MT, FB, CI, AL, MG, MV, JS and MC contributed substantially to the manuscript writing. JGA and SK act as guarantors. Both accept full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

    • Funding Gipuzkoa: this study was funded by grants from Instituto de Salud Carlos III (FIS-PI18/01237 incl. FEDER funds) and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain). Sabadell: this study was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; PI041436; PI081151 incl. FEDER funds; PI12/01890 incl. FEDER funds; CP13/00054 incl. FEDER funds; PI15/00118 incl. FEDER funds; CP16/00128 incl. FEDER funds; PI16/00118 incl. FEDER funds; PI16/00261 incl. FEDER funds; PI17/01194 incl. FEDER funds; PI17/01340 incl. FEDER funds; PI18/00547 incl. FEDER funds; PI20/01695 incl. FEDER funds), CIBERESP, Generalitat de Catalunya-CIRIT 1999SGR 00241, Generalitat de Catalunya-AGAUR (2009 SGR 501, 2014 SGR 822), Fundació La marató de TV3 (090430), Spanish Ministry of Economy and Competitiveness (SAF2012-32991 incl. FEDER funds), Agence Nationale de Securite Sanitaire de l’Alimentation de l’Environnement et du Travail (1262C0010; EST-2016 RF-21; EST-19 RF-04; 2019/1/233), EU Commission (261357, 308333, 603794; 634453; 825712 and 874583). Valencia: this study was funded by Grants from UE (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), Spain: ISCIII (G03/176; FIS-FEDER: PI11/01007, PI11/02591, PI11/02038, PI12/00610, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, and PI17/00663; Miguel Servet-FEDER CP11/00178, CP15/00025, and MSII16/00051), Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244 and UGP-15-249), and Alicia Koplowitz Foundation 2017. Menorca: this study was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; 97/0588; 00/0021-2; PI061756; PS0901958; PI14/00677 incl. FEDER funds), CIBERESP, Beca de la IV convocatoria de Ayudas a la Investigación en Enfermedades Neurodegenerativas de La Caixa, and EC Contract No. QLK4-CT-2000-00263. SK was funded by a Marie Sklodowska Curie Individual Fellowship by the European Commission (80513); CR was the recipient of a European Respiratory Society Fellowship (RESPIRE3-2E01703-00127), under H2020 - Marie Skłodowska-Curie actions COFUND; Maribel Casas and Mònica Guxens received funding from the Instituto de Salud Carlos III Miguel Servet Fellowship (MS16/00128 and CPII18/00018). The Barcelona Institute for Global Health (ISGlobal) receives support from the Spanish Ministry of Science, Innovation and Universities through the 'Centro de Excelencia Severo Ochoa 2019–2023' Programme (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Programme.

    • Competing interests JGA has received payment for lectures from AstraZeneca, Esteve and Chiesi.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.