Early life body mass index trajectories and albuminuria in midlife: A 30-year prospective cohort study.
Early life body mass index trajectories and albuminuria in midlife: A 30-year prospective cohort study.
复制标题
早期体重指数轨迹和中年蛋白尿：一项 30 年前瞻性队列研究
DOI：
10.1016/j.eclinm.2022.101420
复制
发表时间：
2022-06
影响因子：
15.1
通讯作者：
中科院分区：
文献类型：
--
作者：
蛋白尿是血管功能障碍的标志，与慢性肾脏和心血管疾病有关。关于生命早期体重变化的纵向模式与生命后期蛋白尿之间关系的数据有限。我们的目的是确定30年的身体质量指数（BMI）轨迹，并评估其与中年蛋白尿的关系。1987年3月10日至2017年6月3日，中国北方汉中青少年高血压研究队列招募了4623名6 - 18岁的参与者，共纳入了1825名参与者，随访6次，随访时间超过30年。在纵向分析中，使用基于组的轨迹建模来识别不同的BMI轨迹。蛋白尿定义为尿白蛋白与肌酐比值(uACR)≥30mg /g。三种不同的BMI轨迹被确定：低增加（n = 671, 36.8%）、中等增加（n = 940, 51.5%）和高增加（n = 214, 11.7%）；男性参与者的身体质量指数比女性增加得更快。uACR从低增加组到高增加组呈线性增加。共有201人出现蛋白尿，发病率为11.0%。与低升高组相比，在充分调整年龄、性别、吸烟、饮酒、婚姻状况、收缩压、糖尿病、高脂血症等因素后，高升高组中年蛋白尿的比值比（OR）为2.13（95%可信区间[CI]: 1.26 ~ 3.61）。BMI高升高组男性未调整的or值为5.08(2.76-9.37)，女性为3.45(1.78-6.69)，在完全调整模型中，男性的相关性仍然显著。较高的BMI轨迹与较高的uACR和中年蛋白尿风险增加有关，尤其是男性。从早期确定长期BMI轨迹可能有助于预测以后生活中肾脏疾病和心血管疾病的风险。国家自然科学基金项目（81600327、82070437、81870319、82070549、82170437）、陕西省自然科学基础研究计划项目（2021JM-257、2021JM-588）、西安交通大学第一附属医院科研基金项目（2019QN-06、2021zx -14）、西安交通大学第一附属医院临床研究奖项目（XJTU1AF-CRF-2019-004、XJTU1AF2021CRF-021、西安交通大学第一附属医院临床研究奖项目）西安市人民医院科研孵化基金（FZ-61），国家科技部慢性非传染性疾病防治研究重点项目（2017YFC1307604和2016YFC1300104）。
Albuminuria is a marker of vascular dysfunction and is associated with chronic renal and cardiovascular diseases. Data on the association between the longitudinal patterns of weight change early in life and albuminuria later in life are limited. We aimed to identify the body mass index (BMI) trajectory across a 30-year span and evaluate its association with middle-age albuminuria. Of the 4623 participants aged 6–18-year-old recruited by Hanzhong Adolescent Hypertension Study cohort in northern China from March 10, 1987 to June 3, 2017, a total of 1,825 participants followed up with 6 visits over 30 years were enrolled. Group-based trajectory modeling was used to identify distinct BMI trajectories in longitudinal analyses. Albuminuria was defined as a urinary albumin-to-creatinine ratio (uACR) ≥ 30 mg/g. Three distinct BMI trajectories were identified: low-increasing (n = 671, 36.8%), moderate-increasing (n = 940, 51.5%), and high-increasing (n = 214, 11.7%); male participants exhibited a steeper increase in BMI than females. The uACR was increased linearly from the low- to high-increasing group. A total of 201 individuals developed albuminuria, with an incidence of 11.0%. Compared with the low-increasing group, the odds ratio (OR) of albuminuria in middle age was 2.13(95% confidence interval [CI]: 1.26 to 3.61) for the high-increasing group after full adjustment for age, sex, smoking, alcohol consumption, marital status, systolic blood pressure, diabetes, and hyperlipidemia. The unadjusted ORs of the high-increasing BMI group were 5.08 (2.76–9.37) for males and 3.45 (1.78–6.69) for females, and the association remained significant in males in the fully adjusted models. Higher BMI trajectories are associated with higher uACR and an increased risk of albuminuria in middle age, especially in males. Identifying long-term BMI trajectories from an early age may assist in predicting the risk of renal diseases and cardiovascular disease later in life. This work was supported by the National Natural Science Foundation of China (81600327, 82070437, 81870319, 82070549, and 82170437), Natural Science Basic Research Program of Shaanxi Province (2021JM-257 and 2021JM-588), Institutional Foundation of the First Affiliated Hospital of Xi'an Jiaotong University (2019QN-06 and 2021ZXY-14), the Clinical Research Award of the First Affiliated Hospital of Xi'an Jiaotong University of China (XJTU1AF-CRF-2019-004, XJTU1AF2021CRF-021, and XJTU1AFCRF-2017-021), Research Incubation Fund of Xi'an People's Hospital (FZ-61), Grants from the Major Chronic Non-communicable Disease Prevention and Control Research Key Project of the Ministry of Science and Technology of China (2017YFC1307604 and 2016YFC1300104).
登录
查看更多内容
影响因子：
6.1
作者：
Chagnac, Avry;Herman, Michal;Gafter, Uzi
通讯作者：
Gafter, Uzi
影响因子：
13.6
作者：
Henegar, JR;Bigler, SA;Hall, JE
通讯作者：
Hall, JE
儿童期危险因素与26年后动脉硬化的关联：汉中青少年高血压队列
影响因子：
4.9
作者：
Chu, Chao;Dai, Yi;Wang, Yang
通讯作者：
Wang, Yang
DOI：
10.3760/cma.j.issn.0253-3758.2016.10.002
发表时间：
2016-10-24
期刊：
Zhonghua xin xue guan bing za zhi
影响因子：
--
作者：
Hu, D Y
通讯作者：
Hu, D Y
影响因子：
16.2
作者：
Kramer H;Reboussin D;Bertoni AG;Marcovina S;Lipkin E;Greenway FL 3rd;Brancati FL;Look Ahead Research Group
通讯作者：
Look Ahead Research Group