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. Data are available upon reasonable request. The informed consent obtained from all included participants does not allow the data to be made freely available through any third party maintained public repository. However, data used for this submission can be made available on request to the corresponding cohort executive. The ALSPAC website provides information on how to request and access its data (). For queries regarding access of data from MAAS, IoW, SEATON or Ashford contact Philip Couch philip.couch@manchester.ac.uk).

中文翻译：

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从学龄期到成年期的肺功能轨迹及其与心血管疾病风险标志物的关系


基本原理 成年早期的肺功能与随后的不良健康结果相关。目的 确定是否可以在不同人群中得出稳定且可重复的肺功能轨迹，并研究其与心血管结构和功能的客观测量的关联。方法 使用潜在轮廓模型，我们研究了三个基于人群的出生队列，并使用从童年到成年早期的重复肺活量测定数据，以确定 1 秒用力呼气量 (FEV1)/用力肺活量 (FVC) 的轨迹。我们使用多项逻辑回归模型来研究导出轨迹的早期预测因子。然后，我们在一个队列中约 3200 名 24 岁参与者中确定了导出的 FEV1/FVC 轨迹与血压以及心血管风险和中风增加的超声心动图标志物之间的关联程度。结果 我们确定了四个 FEV1/FVC 轨迹，在队列中具有惊人相似的潜在特征（汇总 N=6377）：高于平均水平（49.5%）；平均（38.3%）；低于平均水平（10.6%）；并持续较低（1.7%）。在所有队列中，男性、喘息、哮喘诊断/药物治疗和过敏致敏均与肺功能下降的轨迹相关。我们发现通过超声心动图确定的心血管风险标志物增加的证据（包括与高度和颈动脉内膜中层厚度相关的左心室质量）随着 FEV1/FVC 的降低（每条轨迹的平均粗效应 p 值范围为 0.10 至 p） <0 id=54>）。有关访问 MAAS、IoW、SEATON 或 Ashford 数据的疑问，请联系 Philip Couch（philip.couch@manchester.ac.uk）。