Is slower early growth beneficial for long-term cardiovascular health?
Is slower early growth beneficial for long-term cardiovascular health?
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DOI：
10.1161/01.cir.0000118500.23649.df
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发表时间：
2004-03-09
期刊：
影响因子：
37.8
通讯作者：
Lucas, A
中科院分区：
文献类型：
--
作者：
Singhal, A;Cole, TJ;Lucas, A
背景-新生儿生长加速会增加动物患心血管疾病(CVD)的晚些时候的倾向，而较慢的生长被认为具有有益的影响。为了在人类中验证这一假说，我们测量了早期生长较慢的人群和健康对照组的血流介导的内皮依赖性扩张(FMD)。方法和结果-高分辨率血管超声被用来测量13至16岁的青少年中反应性充血的反应，这些青少年是早产儿队列中的一部分，并进行了前瞻性的随访(n=216)或对照组(n=61)。出生后头2周体重增加或直线增长与青春期较低的FMD相关(回归系数，平均动脉直径每增加100g体重变化-0.026 mm；95%CI，-0.040~-0.012 mm；P=0.0003)，与出生体重和潜在的混杂因素无关。早产儿早期生长速度最低的一半早产儿的平均FMD值高于生长最快的一半(P=0.001.0 5)和足月儿(P=0.0 3)。结论早产儿出生后2周体重增加最快的青少年的FMD值比最低的体重增加率低4%，与成人胰岛素依赖型糖尿病或吸烟的影响相似。我们的发现与新生儿生长加速对长期心血管健康的不利影响是一致的，并表明出生后生长模式可以解释先前报道的出生体重和后来的心血管疾病之间的联系。
Background - Accelerated neonatal growth increases the later propensity to cardiovascular disease (CVD) in animals, whereas slower growth is thought to have a beneficial effect. To test this hypothesis in humans, we measured flow-mediated endothelium-dependent dilation (FMD) in a population subject to slower early growth and in healthy controls.Methods and Results - High-resolution vascular ultrasound was used to measure the change in brachial artery diameter in response to reactive hyperemia in adolescents age 13 to 16 years who were either part of a cohort born preterm and followed up prospectively (n = 216) or controls born at term ( n = 61). Greater weight gain or linear growth in the first 2 weeks postnatally was associated with lower FMD at adolescence ( regression coefficient, - 0.026-mm change in mean arterial diameter per 100-g increase in weight; 95% CI, - 0.040 to - 0.012 mm; P = 0.0003) independent of birthweight and potential confounding factors. Mean FMD in the half of the preterm population with the lowest rates of early growth was higher than in both the half with the greatest growth ( P = 0.001) and subjects born at term ( P = 0.03).Conclusions - FMD was 4% lower in adolescents with the highest compared with the lowest rate of weight gain in the first 2 weeks after birth, a substantial negative effect similar to that for insulin-dependent diabetes mellitus or smoking in adults. Our findings are consistent with the adverse effects of accelerated neonatal growth on long-term cardiovascular health and suggest that postnatal growth patterns could explain the previously reported association between birthweight and later CVD.