Fetal, infant, and childhood growth and adult blood pressure - A longitudinal study from birth to 22 years of age
Fetal, infant, and childhood growth and adult blood pressure - A longitudinal study from birth to 22 years of age
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DOI：
10.1161/hc0902.104677
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发表时间：
2002-03-05
期刊：
影响因子：
37.8
通讯作者：
de Swiet, M
中科院分区：
文献类型：
--
作者：
Law, CM;Shiell, AW;de Swiet, M
出生时身材矮小的人在以后的生活中往往有较高的血压。然而，目前还不清楚是否是胎儿生长受限或出生后的加速生长，往往遵循它，导致血压higher-pressure.Methods和结果，我们研究了血压在346英国男性和女性年龄在22岁的大小已被测量出生时，并为第一个10年的生活。他们的童年成长特点是使用条件的方法。不受回归到平均值的影响。估计追赶增长。出生时身材矮小但在儿童早期（1至5岁）体重迅速增加的人成年后血压最高。收缩压增加1.3 mm Hg（95% CI。0.3出生体重每降低一个标准差，其平均值增加1.6 mm Hg（95% CI，0.6 - 2.7）;儿童早期体重每增加一个标准差，其平均值增加1.6 mm Hg（95% CI，0.6 - 2.7）。调整成人体重指数减弱了儿童早期体重增加的影响，但对出生体重没有影响。舒张压的相关性较小。出生后第一年的体重增加并不影响成人血压。结论：成人高血压的部分风险是在胎儿期确定的。儿童早期体重加速增加增加了这种风险，这部分是通过预测成人肥胖来介导的。高血压的一级预防可能取决于促进胎儿生长和减少儿童肥胖的策略。
Background-People who are small at birth tend to have higher blood pressure in later life. However, it is not clear whether it is fetal growth restriction or the accelerated postnatal growth that often follows it that leads to higher blood pressure.Methods and Results-We studied blood pressure in 346 British men and women aged 22 years whose size had been measured at birth and for the first 10 years of life. Their childhood growth was characterized using a conditional method that. free from the effect of regression to the mean. estimated catch-up growth. People who had been small at birth but who gained weight rapidly during early childhood (1 to 5 years) had the highest adult blood pressures. Systolic pressure increased by 1.3 mm Hg (95% Cl. 0.3 to 2.3) for every standard deviation score decrease in birth weight and, independently, increased by 1.6 mm Hg (95% Cl, 0.6 to 2.7) for every standard deviation score increase in early childhood weight gain. Adjustment for adult body mass index attenuated the effect of early childhood weight gain but not of birth weight. Relationships were smaller for diastolic pressure. Weight gain in the first year of life did not influence adult blood pressure.Conclusions-Part of the risk of adult hypertension is set in fetal life. Accelerated weight gain in early childhood adds to this risk, which is partly mediated through the prediction of adult fatness. The primary prevention of hypertension may depend on strategies that promote fetal growth and reduce childhood obesity.