Association of height growth in puberty with lung function in later life: a longitudinal study

Rationale: Pubertal timing has been suggested to influence lung function – particularly in girls. The rationale is to explore the mechanism of this.

Objectives: To examine associations of timing and velocity of pubertal height growth with maximally attained lung functions and their levels in adolescence from a contemporary population of British young adults participating in a longitudinal birth cohort study.

Methods: We conducted a longitudinal analysis of repeat height measurements for 4,772 males and 4,849 females from age 5 to 20 years to characterise height growth trajectories around the time of puberty using SITAR model, a non-linear mixed effects model. Exposures were defined as age (APHV), and magnitude of peak height velocity (PHV). Spirometry measures were prebronchodilator and post-bronchodilator FEV1, FVC, FEV1/FVC and FEF25 75. Associations at age 15 and 24 years were investigated using multivariable linear regression models adjusted for lung function at age 8 years, height and age at clinic visits for spirometry, in addition to potential confounders.

Measurements and Main Results: Positive associations were found between timing and intensity of pubertal height spurt and FVC at age 24 years, which were more pronounced in males. No associations were found with FEV1/FVC. A 1-year increase in APHV was associated with a 260 ml higher maximally attained FVC (95% confidence interval: 151, 369) for males, 124 ml (70, 178) for female. A 1-cm/year increase in PHV was associated with 150 ml (49, 250) and 50 ml (2, 99) increase in FVC for males and females respectively.

Conclusions: Earlier onset and lower velocity of pubertal height growth are associated with reduced FVC in young adults around the time of peak lung function.