Mother's body size and placental size predict coronary heart disease in men
Mother's body size and placental size predict coronary heart disease in men
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DOI：
10.1093/eurheartj/ehr147
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发表时间：
2011-09-01
影响因子：
39.3
通讯作者：
Barker, David J. P.
中科院分区：
文献类型：
--
作者：
Eriksson, Johan G.;Kajantie, Eero;Barker, David J. P.
出生体重接近正常范围下限的人患冠心病的风险增加。这是由于胎儿编程通过营养不良，但营养不良的原因是未知的。方法和结果，我们研究了6975名男子出生在赫尔辛基在1934年至1944年。他们出生时的大小被记录下来。后来患冠心病的婴儿往往有较低的体重指数（出生体重/身长（3））。三种不同的胎盘表型预测疾病。在身高低于中位值的矮小孕妇中，胎盘表面的长宽差每增加1厘米，患病风险比为1.14（95%置信区间1.08-1.21，P < 0.0001）。在高个子母亲中，体重指数高于中位数，表面积每减少40 cm（2），风险比为1.25（1.10-1.42，P = 0.0007）。在高个子母亲的体重指数低于中位数，危险比为1.07（1.02-1.13，P = 0.01）每增加1%的胎盘重量/出生体重ratio.Conclusions三种不同的组合的母亲和胎盘大小预测冠心病。母亲的身体大小决定了营养的可用性，并与胎盘的发育和功能有关，反映在其形状和大小上。我们推测正常胎盘发育的三个过程的变化会导致胎儿营养不良。这些过程是（i）植入和螺旋动脉侵入，（ii）绒毛膜表面的生长，和（iii）绒毛膜表面的代偿性扩张。
Aims People whose birthweights were towards the lower end of the normal range are at increased risk of coronary heart disease. This is attributed to foetal programming through malnutrition, but the cause of the malnutrition is unknown.Methods and results We studied 6975 men born in Helsinki during 1934-44. Their size at birth was recorded. Babies who later developed coronary heart disease tended to have a low ponderal index (birthweight/length(3)). Three different placental phenotypes predicted the disease. In primiparous mothers who were short, having below median height, the hazard ratio for the disease was 1.14 (95% confidence interval 1.08-1.21, P < 0.0001) for each centimetre increase in the difference between the length and breadth of the placental surface. In tall mothers whose body mass index was above the median, the hazard ratio was 1.25 (1.10-1.42, P = 0.0007) per 40 cm(2) decrease in the surface area. In tall mothers whose body mass index was below the median, the hazard ratio was 1.07 (1.02-1.13, P = 0.01) per 1% increase in the placental weight/birthweight ratio.Conclusions Three different combinations of maternal and placental size predicted coronary heart disease. The mother's body size determines the availability of nutrients and is linked to the development and function of the placenta, reflected in its shape and size. We speculate that variations in three processes of normal placental development lead to foetal malnutrition. The processes are (i) implantation and spiral artery invasion, (ii) growth of the chorionic surface, and (iii) compensatory expansion of the chorionic surface.