Catch-up growth in childhood and death from coronary heart disease:: longitudinal study
Catch-up growth in childhood and death from coronary heart disease:: longitudinal study
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DOI：
10.1136/bmj.318.7181.427
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发表时间：
1999-02-13
影响因子：
105.7
通讯作者：
Barker, DJP
中科院分区：
文献类型：
--
作者：
Eriksson, JG;Forsén, T;Barker, DJP
目的 研究儿童时期的追赶性生长是否会改变因宫内生长减少而导致的冠心病死亡风险增加。设计 对出生时的体型进行跟踪研究，并在整个童年期间平均测量 10 次身高和体重。研究地点为芬兰赫尔辛基。受试者为 3041 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男性。主要结果指标冠心病死亡的风险比。结果 冠心病死亡与低出生体重有关，更重要的是，与出生时体重指数低有关。死于冠心病的男性在 7 至 15 岁的各个年龄段的体重指数均高于平均水平。在同步回归中，出生时体重指数每降低一个单位（kg/m(3)），疾病死亡的风险比就会增加 14%（95%，置信区间 8% 到 19%；P < 0.0001）；11 岁时体重指数每增加一个单位（kg/m(2)），疾病死亡的风险比就会增加 22%（10% 到 36%；P = 0.0001）。儿童时期的体重指数与母亲的体重指数密切相关，而母亲的体重指数又与冠心病相关。童年时期家庭拥挤程度虽然与童年时期的体重指数有关，但与后来的冠心病无关。 结论 冠心病死亡率最高的男孩是出生时体重较瘦，但从 7 岁起体重就赶上平均水平或高于平均水平的男孩。冠心病死亡可能是产前营养不良和产后营养改善的结果。
Objective To examine whether catch-up growth during childhood modifies the increased risk of death from coronary heart disease that is associated with reduced intrauterine growth.Design Follow up study of men whose body size at birth, was recorded and who had an average of 10 measurements taken of their height and weight through childhood.Setting Helsinki, Finland.Subjects 3041 men who were born in Helsinki University Central Hospital during 1924-33 and who went to school in Helsinki.Main outcome measures Hazard ratios fur death from coronary heart disease.Results Death from coronary heart disease was associated with low birth weight and, more strongly, with a low ponderal index at birth. Men who died from coronary heart disease had an above average body mass index at all ages from 7 to 15 years. In a simultaneous regression the hazard ratio for death from the disease increased by 14% (95%, confidence interval 8% to 19%; P < 0.0001) for each unit (kg/m(3)) decrease in ponderal index at birth and by 22% (10% to 36%; P = 0.0001) for each unit (kg/m(2)) increase in body mass index at 11 years of age. Body mass index in childhood was strongly related to maternal body mass index, which in turn was related to coronary heart disease. The extent of crowding in the home during childhood, although related to, body mass index in childhood, was not related to later coronary heart disease.Conclusion The highest death rates from coronary heart disease occurred in boys who were thin at birth but whose weight caught up so that they had an average or above average body mass from the age of 7 years. Death from coronary heart disease may be a consequence of poor prenatal nutrition followed by improved postnatal nutrition.