論文No1705
Tobacco smoke exposure in early life and adolescence in relation to lung function
Jesse D. Thacher, Erica S. Schultz, Jenny Hallberg, Ulrika Hellberg, Inger Kull, Per Thunqvist, Göran Pershagen, Per M. Gustafsson, Erik Melén, Anna Bergström
European Respiratory Journal 51 (6) 1702111; DOI: 10.1183/13993003.02111-2017 Published 7 June 2018
＜目的＞
妊娠時の母親の喫煙は子供が幼いときの肺機能障害と関連する。
しかし長期的影響、および青年期の自身の喫煙の影響はよくわかっていない。
我々は妊娠時の母親の喫煙の影響、受動喫煙曝露と青年期の喫煙が16歳時の肺機能に与える影響について検討した。
＜方法＞
BAMSE (Barn/Child, Allergy, Milieu, Stockholm, Epidemiology)出生コホート研究で質問票を繰り返すことで
参加者のタバコ曝露の情報を集めた。
また唾液中のコチニン濃度を16歳時に測定した。
16歳時に参加者は肺機能、インパルスオシロメトリ(IOS)を行った(n=2295)。
＜結果＞
妊娠中の喫煙曝露はFEV1/FVC比を-1.1% (95% CI −2.0 to −0.2%)低下させた。
IOSでは妊娠中のタバコ喫煙者の子供は5-20Hz(R5-20)の抵抗が高かった。
青年期の喫煙はFEV1/FVCが−0.9% (95% CI −1.8 to −0.1%)減少し、
R5-20の抵抗が6.5 Pa·L–1·s (95% CI 0.7 to 12.2 Pa·L–1·s) 増加した。
FEV1/FVC比は、≥12 ng·mL−1を青年喫煙のコチニン濃度のカットオフ値とした場合、コチニン濃度と関連した。
＜感想＞
妊娠中の喫煙は子供が16歳時のFEV1/FVCの低下、気道抵抗の増加と関連したようです。
青年期の喫煙もFEV1/FVC低下、気道抵抗の増加と関連したようです。
Maternal smoking during pregnancy is associated with impaired lung function among young children, but less is known about long-term effects and the impact of adolescents' own smoking. We investigated the influence of maternal smoking during pregnancy, secondhand smoke exposure and adolescent smoking on lung function at age 16 years.
The BAMSE (Barn/Child, Allergy, Milieu, Stockholm, Epidemiology) birth cohort collected information on participants' tobacco smoke exposure through repeated questionnaires, and measured saliva cotinine concentrations at age 16 years. Participants performed spirometry and impulse oscillometry (IOS) at age 16 years (n=2295).
Exposure to maternal smoking during pregnancy was associated with reduced forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio of −1.1% (95% CI −2.0 to −0.2%). IOS demonstrated greater resistance at 5–20 Hz (R5–20) in participants exposed to maternal smoking during pregnancy. Adolescents who smoked had reduced FEV1/FVC ratios of −0.9% (95% CI −1.8 to −0.1%) and increased resistance of 6.5 Pa·L–1·s (95% CI 0.7 to 12.2 Pa·L–1·s) in R5–20. Comparable associations for FEV1/FVC ratio were observed for cotinine concentrations, using ≥12 ng·mL−1 as a cut-off for adolescent smoking.
Maternal smoking during pregnancy was associated with lower FEV1/FVC ratios and increased airway resistance. In addition, adolescent smoking appears to be associated with reduced FEV1/FVC ratios and increased peripheral airway resistance.