BACKGROUND Limited studies have investigated the influence of body mass index (BMI) trajectories on lung function covering the entire growth period. METHODS We conducted a prospective study utilizing data from the Swedish BAMSE birth cohort. Latent class mixture modelling was employed to examine the diversity in BMI z-scores from birth to 24 years of age. Participants with four or more BMI z-scores were included (n=3204, 78·4%). Pre-bronchodilator (BD) spirometry was tested at 8, 16, and 24 years, while post-BD spirometry, multiple-breath nitrogen washout (for lung clearance index, LCI), and urinary metabolomics data were assessed at 24 years. RESULTS Six distinct BMI development groups were identified. Compared to the stable normal BMI group, the accelerated increasing BMI group exhibited reduced pre- and post-BD FEV1/FVC ratio z scores (β=-0·26, 95% CI=[-0·44, -0·08], and -0·22, [ -0·39, -0·05], respectively), along with elevated LCI (0·30, [0·22, 0·42]) at 24 years. The persistent high BMI group demonstrated lower FEV1, and FVC z scores growth between 16 and 24 years (-0.24, [-0.42, -0.05], and -0.27, [-0.45, -0.01], respectively), and elevated LCI (0·20, [0·03, 0·39]) at 24 years. However, those impairments were not observed in the accelerated resolving BMI group. Conversely, the persistent low BMI group displayed persistently decreased FEV1, and FVC from 8 to 24 years, as well as decreased lung function growth. Additionally, histidine-related metabolites were associated with pre- and post-BD FEV1 (hypergeometric FDR=0.008 and <0.001, respectively). CONCLUSIONS Early interventions aiming for normal BMI during childhood may contribute to improved lung health later in life.

中文翻译：

---

从出生到成年早期的体重指数轨迹和肺功能发育。


背景 有限的研究调查了体重指数 （BMI） 轨迹对涵盖整个生长期肺功能的影响。方法 我们利用瑞典 BAMSE 出生队列的数据进行了一项前瞻性研究。采用潜在类别混合模型来检查从出生到 24 岁 BMI z 评分的多样性。包括具有 4 个或更多 BMI z 评分的参与者 （n=3204， 78·4%）。在 8 、 16 和 24 岁时测试支气管扩张剂前 （BD） 肺活量测定，而在 24 岁时评估 BD 后肺活量测定、多次呼吸氮清除 （肺清除指数，LCI） 和尿液代谢组学数据。结果 确定了 6 个不同的 BMI 发展组。与稳定的正常 BMI 组相比，加速增加的 BMI 组在 24 岁时表现出 BD 前后 FEV1/FVC 比值 z 评分降低 （β=-0·26， 95% CI=[-0·44， -0·08] 和 -0·22， [ -0·39， -0·05]]），以及 LCI 升高 （0·30， [0·22， 0·42]）。持续高 BMI 组在 16 至 24 岁之间表现出较低的 FEV1 和 FVC z 评分增长 （分别为 -0.24， [-0.42， -0.05] 和 -0.27， [-0.45， -0.01]），并在 24 岁时表现出升高的 LCI （0·20， [0·03， 0·39]）。然而，在加速消退 BMI 组中未观察到这些损害。相反，持续低 BMI 组在 8 至 24 岁期间表现出 FEV1 和 FVC 持续降低，以及肺功能生长下降。此外，组氨酸相关代谢物与 BD 前后 FEV1 相关 （分别为超几何 FDR=0.008 和 <0.001）。结论 儿童期以正常 BMI 为目标的早期干预可能有助于改善以后的肺部健康。