TY - JOUR
T1 - Physical activity and lung function-cause or consequence?
AU - Bédard, Annabelle
AU - Carsin, Anne Elie
AU - Fuertes, Elaine
AU - Accordini, Simone
AU - Dharmage, Shyamali C.
AU - Garcia-Larsen, Vanessa
AU - Heinrich, Joachim
AU - Janson, Christer
AU - Johannessen, Ane
AU - Leynaert, Bénédicte
AU - Sánchez-Ramos, José Luis
AU - Peralta, Gabriela P.
AU - Pin, Isabelle
AU - Squillacioti, Giulia
AU - Weyler, Joost
AU - Jarvis, Deborah
AU - Garcia-Aymerich, Judith
N1 - Funding Information:
The present analyses are part of the Ageing Lungs in European Cohorts (ALEC) Study (www.alecstudy.org), which has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement no 633212. The local investigators and funding agencies for the European Community Respiratory Health Survey (ECRHS II and ECRHS III) did not have any role in the study design, in the data collection, analysis and interpretation, in the writing of the report and in the decision to submit the paper for publication. ISGlobal is a member of CERCA Programme, Generalitat de Catalunya.
Publisher Copyright:
© 2020 Bédard et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/8
Y1 - 2020/8
N2 - 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.
AB - 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.
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U2 - 10.1371/journal.pone.0237769
DO - 10.1371/journal.pone.0237769
M3 - Article
C2 - 32817718
AN - SCOPUS:85089768904
SN - 1932-6203
VL - 15
JO - PloS one
JF - PloS one
IS - 8 August
M1 - e0237769
ER -