Long-Term Excessive Body Weight and Adult Left Ventricular Hypertrophy Are Linked Through Later-Life Body Size and Blood Pressure: The Bogalusa Heart Study.
Long-Term Excessive Body Weight and Adult Left Ventricular Hypertrophy Are Linked Through Later-Life Body Size and Blood Pressure: The Bogalusa Heart Study.
复制标题
长期体重过高和成人左心室肥大与晚年体重和血压有关：Bogalusa 心脏研究。
DOI：
10.1161/circresaha.116.310421
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发表时间：
2017-05-12
影响因子：
20.1
通讯作者：
Chen W
中科院分区：
文献类型：
--
作者：
Zhang H;Zhang T;Li S;Guo Y;Shen W;Fernandez C;Harville E;Bazzano LA;Urbina EM;He J;Chen W
儿童期肥胖与以后生活中的心脏结构有关，但关于儿童期体重通过成人体型和血压影响成人左心室几何形状的程度知之甚少。定量确定成人体重和血压对儿童期BMI与成人左室肥厚（LVH）相关性的中介作用。这项纵向研究包括710名年龄在26至48岁之间的成年人，他们在儿童期接受了4次或以上的BMI和BP检测，在成年期接受了2次或以上的BMI和BP检测，平均随访时间为28.0年。在调整年龄、种族和性别后，成人BMI对儿童BMI-成人左室质量指数（LVMI）的关联具有显著的中介作用（76.4%,p<0.01）。成人收缩压（SBP, 15.2%）、长期负担（12.1%）和收缩压升高趋势（7.9%）的中介作用均显著（p<0.01）。此外，这些介质在儿童BMI与成人LVH、偏心和同心肥厚的关联中也有显著的中介作用。成人BMI对LVMI、LVH和左室重构模式的调节作用均显著强于成人收缩压（p<0.01）。收缩压对心性肥厚的调节作用明显强于对偏心性肥厚的调节作用（p<0.01）。这些研究结果表明，儿童时期BMI升高对成人心脏结构的亚临床变化具有长期的不利影响，并且早期体重过重和成年LVH与晚年体重过重和血压升高有关。
Childhood adiposity is associated with cardiac structure in later life, but little is known regarding to what extent childhood body weight affects adult left ventricular geometric patterns through adult body size and blood pressure (BP). Determine quantitatively the mediation effect of adult body weight and BP on the association of childhood BMI with adult left ventricular hypertrophy (LVH). This longitudinal study consisted of 710 adults, age 26 to 48 years, who had been examined for BMI and BP measured 4 or more times during childhood and 2 or more times during adulthood, with a mean follow-up period of 28.0 years. After adjusting for age, race and sex, adult BMI had a significant mediation effect (76.4%, p<0.01) on the childhood BMI-adult LV mass index (LVMI) association. The mediation effects of adult systolic BP (SBP, 15.2%), long-term burden (12.1%) and increasing trends of SBP (7.9%) were all significant (p<0.01). Furthermore, these mediators also had significant mediation effects on the association of childhood BMI with adult LVH, eccentric and concentric hypertrophy. Importantly, the mediation effects of adult BMI were all significantly stronger than those of adult SBP on LVMI, LVH and LV remodeling patterns (p<0.01). Additionally, the mediation effect of SBP on concentric hypertrophy was significantly stronger than on eccentric hypertrophy (p<0.01). These findings suggest that increased childhood BMI has long-term adverse impact on subclinical changes in adult cardiac structure, and early life excessive body weight and adult LVH are linked through later life excessive body weight and elevated BP.