Lamont D, Parker L, White M, Unwin N, Bennett S M, Cohen M, Richardson D, Dickinson H O, Adamson A, Alberti K G, Craft A W
Department of Child Health, University of Newcastle, Sir James Spence Institute of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP.
BMJ. 2000 Jan 29;320(7230):273-8. doi: 10.1136/bmj.320.7230.273.
To quantify the direct and indirect effects of fetal life, childhood, and adult life on risk of cardiovascular disease at age 49-51 years.
Follow up study of the "Newcastle thousand families" birth cohort established in 1947.
154 men and 193 women who completed a health and lifestyle questionnaire and attended for clinical examination between October 1996 and December 1998.
Correlations between mean intima-media thickness of the carotid artery (carotid intima-media thickness) and family history, birth weight, and socioeconomic position around birth; socioeconomic position, growth, illness, and adverse life events in childhood; and adult socioeconomic position, lifestyle, and biological risk markers. Proportions of variance in carotid intima-media thickness that were accounted for by each stage of the lifecourse.
Socioeconomic position at birth and birth weight were negatively associated with carotid intima-media thickness, although only social class at birth in women was a statistically significant covariate independent of adult lifestyle. These early life variables accounted directly for 2.2% of total variance in men and 2.0% in women. More variation in carotid intima-media thickness was explained by adult socioeconomic position and lifestyle, which accounted directly and indirectly for 3.4% of variance in men (95% confidence interval 0.5% to 6.2%) and 7.6% in women (2.1% to 13.0%). Biological risk markers measured in adulthood independently accounted for a further 9.5% of variance in men (2.4% to 14.2%) and 4.9% in women (1.6% to 7.4%).
Adult lifestyle and biological risk markers were the most important determinants of the cardiovascular health of the study members of the Newcastle thousand families cohort at age 49-51 years. The limited overall effect of early life factors may reflect the postwar birth year of this cohort.
量化胎儿期、儿童期和成年期生活对49至51岁心血管疾病风险的直接和间接影响。
对1947年建立的“纽卡斯尔千户家庭”出生队列进行随访研究。
154名男性和193名女性，他们在1996年10月至1998年12月期间完成了健康和生活方式问卷并接受了临床检查。
颈动脉平均内膜中层厚度（颈动脉内膜中层厚度）与家族史、出生体重以及出生前后社会经济地位之间的相关性；儿童期的社会经济地位、生长发育、疾病和不良生活事件；以及成年期社会经济地位、生活方式和生物风险标志物。生命历程各阶段所解释的颈动脉内膜中层厚度方差比例。
出生时的社会经济地位和出生体重与颈动脉内膜中层厚度呈负相关，不过只有女性出生时的社会阶层是独立于成年生活方式的具有统计学意义的协变量。这些早期生活变量直接解释了男性总方差的2.2%和女性总方差的2.0%。成年期社会经济地位和生活方式解释了更多颈动脉内膜中层厚度的变异，它们直接和间接解释了男性方差的3.4%（95%置信区间0.5%至6.2%）和女性方差的7.6%（2.1%至13.0%）。成年期测量的生物风险标志物独立解释了男性方差的另外9.5%（2.4%至14.2%）和女性方差的4.9%（1.6%至7.4%）。
成年生活方式和生物风险标志物是纽卡斯尔千户家庭队列中49至51岁研究对象心血管健康的最重要决定因素。早期生活因素的总体影响有限可能反映了该队列的战后出生年份。
