Growth in utero and during childhood among women who develop coronary heart disease:: longitudinal study
Growth in utero and during childhood among women who develop coronary heart disease:: longitudinal study
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DOI：
10.1136/bmj.319.7222.1403
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发表时间：
1999-11-27
影响因子：
--
通讯作者：
Barker, DJP
中科院分区：
文献类型：
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作者：
Forsén, T;Eriksson, JG;Barker, DJP
目的 检查患有冠心病的女性在胎儿和儿童时期的生长模式是否与患有该疾病的同一队列中的男性不同。设计对出生时的体型进行跟踪研究，并在儿童时期平均测量 10 次身高和体重。研究地点为芬兰赫尔辛基。受试者 3447 名 1924-33 年间出生于赫尔辛基大学中央医院并在赫尔辛基上学的女性。主要结果指标因冠心病入院或死亡。结果 女性冠心病与低出生体重相关（调整妊娠后 P = 0.08，调整胎盘重量后 P = 0.007），并且与出生时身长短相关（分别为 P = 0.001 和 P < 0.0001）。女性出生时身长每减少 rm，患冠心病的风险比就会增加 10.2%（95% 置信区间为 4.3 至 15.7）。出生时身长较短对女性的影响最大，她们在出生后身高“追赶”，因此她们在女孩时期就很高。这样的女孩往往有高个子的母亲。相比之下，患有该疾病的同一队列中的男性出生时较瘦，而不是矮，表现出体重而不是身高的“追赶”增长，而他们的母亲往往超重而不是高大。 结论 女性和男性中的冠心病反映了产前营养不良和随之而来的出生时身材矮小，以及产后营养改善和儿童期“追赶”生长。这种疾病与出生时区分两性的身体比例的下降有关——女性身体长度短，男性身体瘦弱。
Objective To examine whether women who develop coronary heart disease have different patterns of fetal and childhood growth from men in the same cohort who develop the disease.Design Follow up study of women whose body size at birth was recorded and who had an average of 10 measurements of height and weight during childhood.Setting Helsinki, Finland.Subjects 3447 women who were born in Helsinki University Central Hospital during 1924-33 and who went to school in Helsinki.Main outcome measures Hazard ratios for hospital admission for or death from coronary heart disease. Results Coronary heart disease among women was associated with low birth weight (P = 0.08 after adjustment for gestation, P = 0.007 after adjustment for placental weight) and was more strongly associated with short body length at birth (P = 0.001 and P < 0.0001, respectively). The hazard ratio for women developing coronary heart disease increased by 10.2% (95% confidence interval 4.3 to 15.7) for each rm decrease in length at birth. The effect of short length at birth was greatest in women whose height "caught up" after birth so that as girls they were tall. Such girls tended to have tall mothers. In contrast, men in the same cohort who developed the disease were thin at birth rather than short, showed "catch up" growth in weight rather than height, and their mothers tended to be overweight rather than tall.Conclusion Coronary heart disease among both women and men reflects poor prenatal nutrition and consequent small body size at birth combined with improved postnatal nutrition and "catch up" growth in childhood. The disease is associated with reductions in those aspects of body proportions at birth that distinguish die two sexes-short body length in women and thinness in men.