Is birth weight a risk factor for ischemic heart disease in later life?
Is birth weight a risk factor for ischemic heart disease in later life?
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DOI：
10.1093/ajcn/85.5.1244
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发表时间：
2007-05-01
影响因子：
7.1
通讯作者：
Collins, Rory
中科院分区：
文献类型：
--
作者：
Huxley, Rachel;Owen, Christopher G.;Collins, Rory
背景：观察性研究发现出生体重与缺血性心脏病(IHD)呈负相关。目的：我们想要确定出生体重与随后的IHD之间的联系的强度和一致性。设计：我们对观察性研究进行了系统回顾。结果：确定了17项关于出生体重和随后的IHD的已发表研究，总共包括144 794名单身人士。对出生体重和IHD之间关系的相对风险估计来自其中16项研究。来自2项未发表的3801人研究的其他数据也被包括在内。总体而言，这些分析包括来自18项研究的数据，这些研究涉及147 009人中4210例非致命性和3308例致命性IHD事件。出生体重与非致命性和致死性先天性心脏病合并结局的加权平均估计值为每公斤出生体重0.84(95%CI：0.81，0.88)(P<；0.0001)。不同研究的估计值之间没有显著的异质性(P=0.09)，也没有发表偏倚的证据(P=0.3，Begg检验)。无论是将分析局限于致命的IHD事件，还是调整社会经济地位，都没有对结果产生任何明显的影响。结论：这些发现与出生体重增加1公斤与随后发生IHD的风险降低10%-20%相一致。然而，即使是因果关系，增加出生体重的干预措施也不太可能实质性地降低IHD的发生率。需要进一步的研究来确定观察到的关联是否反映了与相关暴露的更强的潜在关联，或者是(至少部分)由于残留的混杂。
Background: An inverse association between birth weight and ischemic heart disease (IHD) has been seen in observational studies.Objective: We wanted to determine the strength and consistency of the association between birth weight and subsequent IHD. Design: We conducted a systematic review of observational studies.Results: Seventeen published studies of birth weight and subsequent IHD were identified that included a total of 144 794 singletons. Relative risk estimates for the association between birth weight and IHD were available from 16 of these studies. Additional data from 2 unpublished studies of 3801 persons were also included. In total, the analyses included data from 18 studies on 4210 nonfatal and 3308 fatal IHD events in 147 009 persons. The mean weighted estimate for the association between birth weight and the combined outcome of nonfatal and fatal IHD was 0.84 (95% CI: 0.81, 0.88) per kilogram of birth weight (P < 0.0001). No significant heterogeneity was observed between estimates in different studies (P = 0.09), nor was there evidence of publication bias (P = 0.3, Begg test). Neither restricting the analysis to fatal IHD events nor adjusting for socioeconomic status had any appreciable effect on the findings.Conclusions: These findings are consistent with a I kg higher birth weight being associated with a 10-20% lower risk of subsequent IHD. However, even if causal, interventions to increase birth weight are unlikely to reduce the incidence of IHD materially. Further studies are needed to determine whether the observed association reflects a stronger underlying association with a related exposure or is due (at least in part) to residual confounding.