Adipose and height growth through childhood and blood pressure status in a large prospective cohort study.
Adipose and height growth through childhood and blood pressure status in a large prospective cohort study.
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一项大型前瞻性队列研究中的儿童期脂肪和身高增长以及血压状况。
DOI：
10.1161/hypertensionaha.111.187716
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发表时间：
2012-05
期刊：
影响因子：
--
通讯作者：
Deanfield JE
中科院分区：
文献类型：
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作者：
Jones A;Charakida M;Falaschetti E;Hingorani AD;Finer N;Masi S;Donald AE;Lawlor DA;Smith GD;Deanfield JE
血压升高（BP）是世界上最主要的死亡风险因素。儿童血压在很大程度上可以预测成人水平，尽管产前和产后生长都会影响它，但它们的相对重要性仍存在争议。在一项针对 12962 名健康儿童的纵向研究（雅芳父母和儿童纵向研究）中，我们旨在评估不同生长时期以及身高与身高别体重（肥胖标志物）的标准化测量对 10 岁时血压的相对影响。使用条件生长模型对 3230 名男孩和 3346 名女孩进行血压测量。收缩压与出生体重和身高别体重呈负相关，但与身长无关（分别为-0.33、-0.27 和-0.12 mm Hg·SD-1；P=0.003、0.035 和0.35）。在婴儿期，体重、身高别体重和身高增长均与收缩压呈正相关（分别为 0.90、0.41 和 0.82 mm Hg·SD−1；所有 P<0.001）。婴儿期后，所有生长方式均与收缩压呈正相关（体重，1.91；体重身高比，1.56；身高，1.20 mm Hg·SD−1；所有 P<0.001）。与舒张压也存在类似但较弱的关联。尽管10岁时血压与产前和产后早期生长有关，但与后期生长相比，其影响较小。由于相对于人口的血压排名基本上是在生命的前十年决定的，因此从婴儿期开始关注减少肥胖发展的策略，而不是强调母亲和婴儿的营养和体重，应该会更大程度地降低人口血压。
Raised blood pressure (BP) is the world’s leading mortality risk factor. Childhood BP substantially predicts adult levels, and although both prenatal and postnatal growth influence it, their relative importance is debated. In a longitudinal study (Avon Longitudinal Study of Parents and Children) of 12 962 healthy children, we aimed to assess the relative contribution of different growth periods and of standardized measures of height versus weight-for-height (an adiposity marker) to BP at age 10 years. Conditional growth modeling was used in the 3230 boys and 3346 girls with BP measurements. Systolic BP was inversely associated with birth weight and weight-for-height but not length (−0.33, −0.27, and −0.12 mm Hg · SD−1; P=0.003, 0.035, and 0.35, respectively). In infancy, weight, weight-for-height, and height gains were all positively associated with systolic BP (0.90, 0.41, and 0.82 mm Hg · SD−1, respectively; all P<0.001). After infancy, all of the growth modalities were positively associated with systolic BP (weight, 1.91; weight-for-height, 1.56; height, 1.20 mm Hg · SD−1; all P<0.001). Similar but weaker associations were found with diastolic BP. Although BP at 10 years was associated with both prenatal and early postnatal growth, their influence was small compared with that of later growth. Because BP ranking relative to the population is substantially determined in the first decade of life, a focus on strategies to reduce the development of adiposity from infancy onward, rather than an emphasis on the nutrition and weight of mothers and infants, should bring greater reductions in population BP.