背景:儿童肥胖与成人心脏病风险之间的因果关系尚未得到明确证实。这项研究旨在确定基因预测的儿童体重指数(BMI)和儿童肥胖是否与成人冠心病有因果关系。心肌梗塞,心力衰竭,心房颤动,肥厚型心肌病,和肺心病.
结果:为了研究儿童肥胖与成人心脏病之间的因果关系和潜在机制,使用了3种主要的孟德尔随机化方法:2个样本孟德尔随机化,多变量孟德尔随机化控制几个心脏代谢风险变量,调解分析。基因预测的儿童体重指数每上升1-SD与24%相关(比值比[OR],1.24[95%CI,1.12-1.37]),28%(或,1.28[95%CI,1.14-1.42]),28%(或,1.28[95%CI,1.14-1.42]),和27%(或,1.27[95%CI,1.04-1.49])冠心病风险较高,心肌梗塞,心力衰竭,心房颤动,分别。儿童肥胖的对数几率每增加1个单位与11%相关(OR,1.11[95%CI,1.06-1.16]),14%(或,1.14[95%CI,1.04-1.23]),10%(或,1.10[95%CI,1.03-1.18]),和20%(或,1.20[95%CI,1.08-1.32])冠心病风险较高,心肌梗塞,心力衰竭,心房颤动,分别。发现儿童肥胖与成人心脏病之间的联系是由高密度脂蛋白胆固醇介导的,甘油三酯,高血压,和2型糖尿病。
结论:我们的研究结果支持儿童肥胖与成人冠心病风险之间的因果关系。心肌梗塞,心力衰竭,和心房颤动。血脂,高血压,和2型糖尿病是介导上述关联的因素。
BACKGROUND: The causal relationship between childhood adiposity and adult risk of heart diseases has not been clearly demonstrated. This
study aims to ascertain whether genetically predicted childhood body mass index (BMI) and childhood obesity are causally associated with adult coronary heart disease, myocardial infarction, heart failure, atrial fibrillation, hypertrophic cardiomyopathy, and pulmonary heart disease.
RESULTS: To investigate the causative relationships and underlying mechanisms between childhood adiposity and adult heart diseases, 3 main methods of Mendelian randomization were used: 2-sample Mendelian randomization, multivariable Mendelian randomization with controlling for several cardiometabolic risk variables, and
mediation analysis. Every 1-SD rise in genetically predicted childhood body mass index was associated with 24% (odds ratio [OR], 1.24 [95% CI, 1.12-1.37]), 28% (OR, 1.28 [95% CI, 1.14-1.42]), 28% (OR, 1.28 [95% CI, 1.14-1.42]), and 27% (OR, 1.27 [95% CI, 1.04-1.49]) higher risk of coronary heart disease, myocardial infarction, heart failure, and atrial fibrillation, respectively. Every 1-unit increase in log-odds in childhood obesity was associated with 11% (OR, 1.11 [95% CI, 1.06-1.16]), 14% (OR, 1.14 [95% CI, 1.04-1.23]), 10% (OR, 1.10 [95% CI, 1.03-1.18]), and 20% (OR, 1.20 [95% CI, 1.08-1.32]) higher risk of coronary heart disease, myocardial infarction, heart failure, and atrial fibrillation, respectively. The link between childhood adiposity and adult heart diseases was found to be mediated by high-density lipoprotein cholesterol, triglyceride, hypertension, and type 2 diabetes.
CONCLUSIONS: Our findings support the causal relationships between childhood adiposity and risk of adult coronary heart disease, myocardial infarction, heart failure, and atrial fibrillation. Blood lipids, hypertension, and type 2 diabetes are factors that mediate the aforementioned associations.