Childhood body-mass index and the risk of coronary heart disease in adulthood
Childhood body-mass index and the risk of coronary heart disease in adulthood
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DOI：
10.1056/nejmoa072515
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发表时间：
2007-12-06
影响因子：
158.5
通讯作者：
Sorensen, Thorkild I. A.
中科院分区：
文献类型：
--
作者：
Baker, Jennifer L.;Olsen, Lina W.;Sorensen, Thorkild I. A.
背景：世界范围内儿童肥胖症的流行正在以惊人的速度发展。超重儿童中冠心病 (CHD) 的危险因素已经明确。然而，儿童体重过重对冠心病的长期影响的严重程度仍不清楚。 方法：我们研究了儿童期（7 至 13 岁）体重指数 (BMI) 与成年期（25 岁或以上）冠心病之间的关联，无论是否对出生体重进行调整。研究对象是 276,835 名丹麦学童，他们的身高和体重测量数据是可用的。 CHD 事件通过与国家登记册的链接来确定。进行了 Cox 回归分析。结果：在 5,063,622 人年的随访中，可获得儿童 BMI 数据的 10,235 名男性和 4318 名女性被诊断为 CHD 或成年后死于 CHD。成人中任何 CHD 事件、非致命事件和致命事件的风险与 7 至 13 岁男孩和 10 至 13 岁女孩的 BMI 呈正相关。这些关联对于每个年龄都是线性的，并且在整个 BMI 分布中风险都会增加。此外，随着孩子年龄的增加，风险也会增加。对出生体重的调整加强了结果。结论：儿童时期较高的体重指数与成年后患冠心病的风险增加相关。这种关联在男孩中比在女孩中更强，并且随着孩子年龄的增长而增加。我们的研究结果表明，随着世界范围内儿童的体重不断增加，他们中越来越多的人在成年后面临患冠心病的风险。
Background: The worldwide epidemic of childhood obesity is progressing at an alarming rate. Risk factors for coronary heart disease (CHD) are already identifiable in overweight children. The severity of the long-term effects of excess childhood weight on CHD, however, remains unknown.Methods: We investigated the association between body-mass index (BMI) in childhood (7 through 13 years of age) and CHD in adulthood (25 years of age or older), with and without adjustment for birth weight. The subjects were a cohort of 276,835 Danish schoolchildren for whom measurements of height and weight were available. CHD events were ascertained by linkage to national registers. Cox regression analyses were performed.Results: In 5,063,622 person-years of follow-up, 10,235 men and 4318 women for whom childhood BMI data were available received a diagnosis of CHD or died of CHD as adults. The risk of any CHD event, a nonfatal event, and a fatal event among adults was positively associated with BMI at 7 to 13 years of age for boys and 10 to 13 years of age for girls. The associations were linear for each age, and the risk increased across the entire BMI distribution. Furthermore, the risk increased as the age of the child increased. Adjustment for birth weight strengthened the results.Conclusions: Higher BMI during childhood is associated with an increased risk of CHD in adulthood. The associations are stronger in boys than in girls and increase with the age of the child in both sexes. Our findings suggest that as children are becoming heavier worldwide, greater numbers of them are at risk of having CHD in adulthood.