Published ahead of print on March 6, 2008, doi:10.1164/rccm.200706-867OC Am. J. Respir. Crit. Care Med., Volume 177, Number 11, June 2008, 1262-1267 A more recent version of this article appeared on June 1, 2008
Submitted on June 14, 2007 Ethnic Difference in Adolescent Lung Function: Anthropometric, Socioeconomic, Psychosocial FactorsMelissa J Whitrow1* and Seeromanie Harding11 Social and Public Health Sciences Unit, Medical Research Council, Glasgow, United Kingdom * To whom correspondence should be addressed. E-mail: melissa{at}sphsu.mrc.ac.uk.
Objective: To examine ethnic differences in lung function in relation to anthropometry, social and psychosocial factors in early adolescence. Methods: 3924 pupils aged 11-13yrs, 80% were ethnic minorities, with satisfactory lung function measures. Data were collected on economic disadvantage (SES), psychological well-being, tobacco exposure, height, Forced Expiratory Volume (FEV1) and Forced Vital Capacity (FVC). Results: The lowest FEV1 was observed for Black Caribbeans/Africans after adjusting for standing height (SH) (Whites: boys 2.475Litres [95% Confidence Interval 2.442, 2.509], girls 2.449L [95%CI 2.464, 2.535]; Black Caribbeans: boys -14% [-16, -12], girls -13% [-16, -11]; Black Africans: boys -15% [-17, -13], girls -17% [-19, -14]; Indians: boys -13% [-16, -11], girls -11% [-14, -8]; Pakistanis/Bangladeshis: boys -7% [-9, -5], girls -9% [-11, -6]). Adjustment for upper body segment (UBS) instead of SH achieved a further reduction in ethnic differences of 41-51% for Black African origin children, and 26-39% for the other groups. Overcrowding (boys) and poor psychological well-being (boys and girls) were independent correlates of FEV1, explaining up to a further 10% of ethnic differences. Similar patterns were observed for FVC. Social exposures were also related to height components. Conclusions: Differences in UBS explained more of the ethnic differences in lung function than SH, particularly among Black Caribbeans/Africans. Social correlates had a smaller but significant impact. Future research needs to consider how differential development of lung capacity is compromised by the social patterning of growth trajectories. Key words: anthropometry, spirometry, ethnicity, socioeconomic factors, adolescence
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