胎龄的出生体重小或大与后来的心血管疾病风险有关。然而,在全球范围内,根据不同纵向环境中的出生体重,从儿童到成年的心血管风险标志物尚未得到广泛研究.
在两个地理和社会经济上不同的队列中,研究从儿童到成年的出生体重与心血管风险之间的关系。
数据来自两项纵向出生队列研究;一项来自芬兰南部(特别图尔库冠状动脉危险因素干预项目,STRIP)和一个来自澳大利亚北部的土著澳大利亚人(原住民出生队列,ABC)。样本包括747名芬兰参与者和541名土著澳大利亚人,他们有出生体重数据,胎龄和心血管危险因素(体重指数[BMI]),腰围与身高比[WHtR],血脂谱,血压)在11、18和25或26岁时收集。在18岁或19岁时评估颈动脉内膜中层厚度(cIMT)。参与者根据胎龄的出生体重进行分类(小[SGA],适当的[AGA]或大的[LGA])。使用重复测量ANOVA研究了出生体重类别与心血管风险标志物之间的关联。
在两个队列中,较高的出生体重类别与较高的BMI相关(对于STRIP,p=.003,对于ABC,p<.0001)。在ABC,较高的出生体重类别也与较高的WHtR相关(p=.004).在ABC,SGA参与者的收缩压和舒张压低于AGA参与者(收缩压p=0.028,舒张压p=.027)和25岁时收缩压低于LGA参与者(p=.046)。在STRIP队列中,SGA参与者的cIMT低于LGA参与者(p=0.024)。
出生体重可以预测不同人群未来的心血管风险状况。因此,需要将其纳入有针对性的公共卫生干预措施中,以应对肥胖大流行并改善全球心血管健康。关键信息出生体重与后来的心血管风险状况之间的最强关联表现为两个文化和地理上不同的队列中体重指数的差异。胎儿生长是不同人群后来心血管健康的决定因素,这表明需要关注孕产妇和胎儿健康,以改善全球心血管健康。
Small or large birth weight for gestational age has been linked with later cardiovascular disease risk. However, cardiovascular risk markers from childhood to adulthood according to birth weight in diverse longitudinal settings globally have not been extensively studied.
To examine the relationship between birth weight and cardiovascular risk profile from childhood until young adulthood in two geographically and socioeconomically distinct cohorts.
Data were derived from two longitudinal birth cohort studies; one from southern Finland (Special Turku Coronary Risk Factor Intervention Project, STRIP) and one from northern Australia comprising Indigenous Australians (Aboriginal Birth Cohort, ABC). The sample included 747 Finnish participants and 541 Indigenous Australians with data on birth weight, gestational age and cardiovascular risk factors (body mass index [BMI]), waist-to-height ratio [WHtR], lipid profile, blood pressure) collected at ages 11, 18 and 25 or 26 years. Carotid intima-media thickness (cIMT) was assessed at age 18 or 19 years. Participants were categorised according to birth weight for gestational age (small [SGA], appropriate [AGA] or large [LGA]). Associations between birth weight category and cardiovascular risk markers were studied using a repeated measures ANOVA.
Higher birth weight category was associated with higher BMI later in life in both cohorts (p=.003 for STRIP and p<.0001 for ABC). In the ABC, higher birth weight category was also associated with higher WHtR (p=.004). In the ABC, SGA participants had lower systolic and diastolic blood pressure than AGA participants (p=.028 for systolic, p=.027 for diastolic) and lower systolic blood pressure than LGA participants (p=.046) at age 25. In the STRIP cohort, SGA participants had lower cIMT than LGA participants (p=.024).
Birth weight can predict future cardiovascular risk profile in diverse populations. Thus, it needs to be included in targeted public health interventions for tackling the obesity pandemic and improving cardiovascular health worldwide.Key messagesThe strongest association between birth weight and later cardiovascular risk profile was manifested as differences in body mass index in two culturally and geographically distinct cohorts.Foetal growth is a determinant for later cardiovascular health in diverse populations, indicating a need to focus on maternal and foetal health to improve cardiovascular health worldwide.