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Vol. 62. Issue 6.
Pages 357-438 (June 2026)
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Vol. 62. Issue 6.
Pages 357-438 (June 2026)
Original Article

Lung Diffusing Capacity at Age 22 and its Life-Course Determinants: Evidence from the 1993 Pelotas Birth Cohort

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Larissa Picançoa,b,
Corresponding author
larissaapicanco@gmail.com

Corresponding author.
, Ana Maria Baptista Menezesa, Paula Duarte de Oliveiraa,b, Priscila Webera,b, Rogelio Perez-Padillac, Fernando C. Wehrmeisterb
a Post graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
b Brazilian Company of Hospital Services (EBSERH), Brasilia, Brazil
c National Institute of Respiratory Diseases (INER), Mexico City, Mexico
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Abstract
Objective

We investigated DLCO parameters at 22 years and associations with socio-demographic, health, and behavioral factors.

Methods

We studied a total of 3350 participants in the 22-year follow-up of the 1993 Pelotas Birth Cohort. DLCO, alveolar volume (VA), and transfer coefficient (KCO) were modeled against perinatal factors and characteristics at 22 years using crude and adjusted linear regressions, stratified by sex.

Results

Maternal smoking during pregnancy was linked to lower DLCO (β=−1.0; 95%CI, −1.72, −0.28) and VA (β=−0.19; 95%CI, −0.33, −0.05) in men. Low birth weight showed lower DLCO (β=−1.21; 95%CI, −2.13, −0.29) and VA (β=−0.29; 95%CI, −0.47, −0.11) in women. Black participants showed lower VA in both sexes and higher KCO in men (β=0.29; 95%CI, 0.14, 0.44). Obesity linked to lower VA and higher KCO in both sexes. Male smokers ≥11cigarettes/day had lower DLCO (β=−4.80; 95%CI, −6.01, −3.59), VA (β=−0.40; 95%CI, −0.64, −0.17), and KCO (β=−0.51; 95%CI, −0.70, −0.32). Female smokers showed higher DLCO and VA but lower KCO (β=−0.25; 95%CI, −0.49, −0.01).

Conclusion

Pulmonary diffusing capacity is shaped by early-life factors and modifiable exposures, including tobacco smoking and obesity. After adjusting for confounders, including time since the last cigarette, to minimize bias related to the absence of hemoglobin or carboxyhemoglobin information, associations remained evident. DLCO serves as an early marker of respiratory and systemic health, supporting prevention strategies and risk stratification in young adults.

Keywords:
Diffusing capacity for carbon monoxide (DLCO)
DLCO/VA (KCO)
Alveolar gas exchange
Respiratory function tests
General population
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