Author:
|
Luzak, Agnes; Fuertes, Elaine; Flexeder, Claudia; Standl, Marie; von Berg, Andrea; Berdel, Dietrich; Koletzko, Sibylle; Heinrich, Joachim; Nowak, Dennis; Schulz, Holger
|
Abstract:
|
BACKGROUND: Various factors may affect lung function at
different stages in life. Since investigations that
simultaneously consider several factors are rare, we examined
the relative importance of early life, current
environmental/lifestyle factors and allergic diseases on lung
function in 15-year-olds. METHODS: Best subset selection was
performed for linear regression models to investigate
associations between 21 diverse early life events and current
factors with spirometric parameters (forced vital capacity,
forced expiratory volume in 1 s and maximal mid-expiratory flow
(FEF25-75)) in 1326 participants of the German GINIplus and
LISAplus birth cohorts. To reduce model complexity, one model
for each spirometric parameter was replicated 1000 times in
random subpopulations (N = 884). Only those factors that were
included in >70% of the replication models were retained in
the final analysis. RESULTS: A higher peak weight velocity and
early lung infections were the early life events prevalently
associated with airflow limitation and FEF25-75. Current
environmental/lifestyle factors at age 15 years and allergic
diseases that were associated with lung function were: indoor
second-hand smoke exposure, vitamin D concentration, body mass
index (BMI) and asthma status. Sex and height captured the
majority of the explained variance (>75%), followed by BMI
(=23.7%). The variance explained by early life events was
comparatively low (median: 4.8%; range: 0.2-22.4%), but these
events were consistently negatively associated with airway
function. CONCLUSIONS: Although the explained variance was
mainly captured by well-known factors included in lung function
prediction equations, our findings indicate early life and
current factors that should be considered in studies on lung
health among adolescents. |