Physical activity and lung function—Cause or consequence?

Concerns exist that the positive association of physical activity with better lung function, which has been suggested in previous longitudinal studies in smokers, is due to reverse causation. To investigate this, we applied structural equation modeling (SEM), an exploratory approach, and marginal st...

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Vydané v:	PloS one Ročník 15; číslo 8; s. e0237769
Hlavní autori:	Bédard, Annabelle, Carsin, Anne-Elie, Fuertes, Elaine, Accordini, Simone, Dharmage, Shyamali C., Garcia-Larsen, Vanessa, Heinrich, Joachim, Janson, Christer, Johannessen, Ane, Leynaert, Bénédicte, Sánchez-Ramos, José Luis, Peralta, Gabriela P., Pin, Isabelle, Squillacioti, Giulia, Weyler, Joost, Jarvis, Deborah, Garcia-Aymerich, Judith
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Public Library of Science 20.08.2020 Public Library of Science (PLoS)
Predmet:	Adolescent Adult Asthma - etiology Asthma - physiopathology Asthma - therapy Biology and Life Sciences Body Weight - physiology Causality Causation Computer and Information Sciences Correlation analysis Diet Epidemiology Exercise Female Forced Expiratory Volume - physiology Global health Health aspects Health Surveys Hospitals Humans Longitudinal Studies Lung Lung - physiology Lungs Male Mathematical models Medicine and Health Sciences Middle Aged Modelling Multivariate statistical analysis Pediatrics Physical activity Physical fitness Population Public health Research and Analysis Methods Respiratory function Respiratory Function Tests Respiratory Tract Infections - therapy Smokers Smoking Smoking - adverse effects Surveys Time dependence Vital Capacity - physiology Young Adult Australia Europe United Kingdom > UK Norway Italy Melbourne Victoria Australia France Spain
ISSN:	1932-6203, 1932-6203
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Shrnutí:	Concerns exist that the positive association of physical activity with better lung function, which has been suggested in previous longitudinal studies in smokers, is due to reverse causation. To investigate this, we applied structural equation modeling (SEM), an exploratory approach, and marginal structural modeling (MSM), an approach from the causal inference framework that corrects for reverse causation and time-dependent confounding and estimates causal effects, on data from participants in the European Community Respiratory Health Survey (ECRHS, a multicentre European cohort study initiated in 1991-1993 with ECRHS I, and with two follow-ups: ECRHS II in 1999-2003, and ECRHS III in 2010-2014). 753 subjects who reported current smoking at ECRHS II, with repeated data on lung function at ECRHS I, II and III, physical activity at ECRHS II and III, and potential confounders at ECRHS I and II, were included in the analyses. SEM showed positive associations between physical activity and lung function in both directions. MSM suggested a protective causal effect of physical activity on lung function (overall difference in mean β (95% CI), comparing active versus non-active individuals: 58 mL (21-95) for forced expiratory volume in one second and 83 mL (36-130) for forced vital capacity). Our results suggest bi-directional causation and support a true protective effect of physical activity on lung function in smokers, after accounting for reverse causation and time-dependent confounding.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0237769