Sex-specific programming of cardiovascular physiology in children
Sex-specific programming of cardiovascular physiology in children
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DOI：
10.1093/eurheartj/ehn292
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发表时间：
2008-09-01
影响因子：
39.3
通讯作者：
Phillips, David I. W.
中科院分区：
文献类型：
--
作者：
Jones, Alexander;Beda, Alessandro;Phillips, David I. W.
越来越多的证据表明，不良的产前环境，如低出生体重，导致心血管生理的长期变化，易患循环系统疾病。其机制知之甚少，大多数人类研究都是在成人中进行的，对早期病理生理变化知之甚少。因此，我们已经评估了出生体重和心血管physiologyinchildh.Methods和结果之间的关系在140个健康的男孩和女孩（7-9岁），出生在长期和前瞻性的，我们连续记录血压，心电图和心脏阻抗之前，期间，和10分钟后的社会心理压力（特里尔社会压力测试儿童）。在男孩中，低出生体重与较高的静息体循环动脉压相关，（β = -6.8 mmHg/kg，P = 0.03）和血管阻力升高的趋势（β = -87达因s/cm（5）/kg，ns）在应力后显著增强（分别为β = -9.5 mmHg/kg，P = 0.003和β = -139 dyne s/cm（5）/kg，P = 0.02）。在女孩中，较低的出生体重与较短的射血前期有关（β = 8.0 ms/kg，P = 0.005）和校正的QT间期（β = 11.9ms/kg，P = 0.003），而应激时无明显变化。结论出生时体型较小与性别特异性的心脏生理学改变有关;男孩的全身血管阻力较高，女孩的心脏交感神经激活增加。
Aims Increasing evidence suggests that adverse prenatal environments, as indicated by low birth weight, cause long-term changes in cardiovascular physiology that predispose to circulatory disease. The mechanisms are poorly understood, most human studies have been carried out in adults and little is known about early pathophysiological changes. Therefore, we have assessed the relationship between birth weight and cardiovascular physiology in children.Methods and results In 140 healthy boys and girls (aged 7-9 years), born at term and followed prospectively, we continuously recorded blood pressure, electrocardiograms and cardiac impedance before, during, and after 10 min of psychosocial stress (Trier Social Stress Test for Children). In boys, an association of lower birth weight with higher resting systemic arterial pressure (beta = -6.8 mmHg/kg, P = 0.03) and a trend towards higher vascular resistance (beta = -87 dyne s/cm(5)/kg, ns) were substantially strengthened following stress (beta= -9.5 mmHg/kg, P = 0.003 and beta = -139 dyne s/cm(5)/kg, P = 0.02, respectively). In girls, lower birth weight was associated with a shorter pre-ejection period (beta = 8.0 ms/kg, P = 0.005) and corrected QT interval (beta = 11.9 ms/kg, P = 0.003) at rest and little changed by stress.Conclusion Smaller size at birth is associated with sex-specific alterations in cardiac physiology; boys had higher systemic vascular resistance and girls had increased cardiac sympathetic activation.