Lower lung function was associated with higher mortality (rate difference 260 excess deaths/10,000 person-years per IQR decrement in FEV1; 95% CI 224-302).
Cohort (n=18,090)
Yes
In a large Canadian cohort, lower lung function was associated with increased mortality, and early-life growth adversity explained a larger proportion of lung function variance than cumulative smoking history or genetic height.
Effect estimate: Rate difference 260 excess deaths/10,000 person-years per IQR decrement in FEV1 (95% CI 224-302)
Abstract Background Lung function scales to adult height and is strongly predictive of survival. Potentially modifiable early-life growth conditions and genetics both contribute to adult height and lung function, but their relative contributions are poorly understood. This study i) evaluated the association of lung function and mortality, and ii) used a validated index of early-life growth adversity to partition the genetic and non-genetic components of adult height and quantify their associations with lung function. Methods The Canadian Longitudinal Study on Aging (CLSA) assessed anthropometry, spirometry, and genotyping in a population-based sample of adults 45 years and older. Genetic height was calculated using a polygenic height score derived from individual genotype data. An index of early-life growth adversity was computed as the difference between attained and genetic height. Modified Poisson regression was used to estimate the person-year mortality rate associated with lung function, and models were adjusted for age, sex, principal components of genetic ancestry, cigarette smoking status and pack-years. Increments in variance explained (R2) for the forced expiratory volume in 1-second (FEV1) and forced vital capacity (FVC) by genetic and non-genetic components of height and, for comparison, cumulative cigarette smoking history, were computed after adjustment for age, sex, and principal components of genetic ancestry. Results Among 18,090 participants (mean±SD age: 62±10 years; 51.8% female), lower lung function was associated with higher mortality (rate difference: 260 excess deaths/10,000 person-years per IQR decrement in FEV1 95%CI: 224-302; 266 excess deaths/10,000 person-years per IQR decrement in FVC 95%CI: 230-309). The index of non-genetic early-life growth adversity explained a larger proportion of FEV1 and FVC variance than genetic height and cumulative cigarette smoking history (Table). Conclusion In a large population-based sample of Canadian adults, lower lung function was associated with all-cause mortality. An index of early-life growth adversity statistically accounted for a larger proportion of lung function variance than cumulative cigarette smoking history or genotype-predicted height. Our results suggest that early-life growth adversity may represent an impactful target to build lung function reserve and improve health across the life course. This abstract is funded by: CIHR
Collins et al. (2026) conducted a cohort in Lung health (n=18,090). Lower lung function and early-life growth adversity vs. Cumulative cigarette smoking history and genetic height was evaluated on All-cause mortality associated with lung function (Rate difference 260 excess deaths/10,000 person-years per IQR decrement in FEV1, 95% CI 224-302). Lower lung function was associated with higher mortality (rate difference 260 excess deaths/10,000 person-years per IQR decrement in FEV1; 95% CI 224-302).