Cheung Y B, Low L, Osmond C, Barker D, Karlberg J
Department of Pediatrics, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR, PR China.
Hypertension. 2000 Nov;36(5):795-800. doi: 10.1161/01.hyp.36.5.795.
It is commonly agreed that birth weight is associated with blood pressure in adults. However, not much is known about birth length, ponderal index, and early postnatal growth, whose effects on adult blood pressure, if any, can affect the interpretation of the birth weight-blood pressure association. This study examined the association between fetal growth, early postnatal growth, and blood pressure in Chinese adults. One hundred twenty-two subjects born in Hong Kong in 1967 were followed from birth to age 30 years. Multiple linear regression was used to analyze the association between size at birth, postnatal changes in body size, and systolic and diastolic blood pressure at age 30 years. Having adjusted for potential confounders and each other explanatory variable, it is found that birth length standard deviation score (regression coefficient or beta=-3.2), ponderal index at birth (beta=-1.8), and postnatal changes in ponderal index from age 6 months to 18 months (beta=-2.2) were inversely associated with systolic blood pressure (each P<0.05). Postnatal changes in length standard deviation score were not significantly associated with systolic blood pressure. Birth length standard deviation score was inversely associated with diastolic blood pressure at age 30 years (beta=-2.6; P<0.05). Other anthropometric variables were not associated with diastolic blood pressure. The results support the hypotheses that both fetal growth and early postnatal growth may have a long-term impact on blood pressure in adults. It also highlights the importance of differentiating length and weight for length.
人们普遍认为出生体重与成年人的血压有关。然而，对于出生身长、体重指数和出生后早期生长情况，我们了解得并不多，它们对成年人血压的影响（如果有影响的话）可能会影响对出生体重与血压关联的解释。本研究调查了中国成年人的胎儿生长、出生后早期生长与血压之间的关联。对1967年在香港出生的122名受试者从出生一直追踪到30岁。采用多元线性回归分析出生时的体型、出生后体型变化与30岁时收缩压和舒张压之间的关联。在对潜在混杂因素和其他解释变量进行调整后，发现出生身长标准差评分（回归系数或β=-3.2）、出生时的体重指数（β=-1.8）以及6个月至18个月龄时体重指数的出生后变化（β=-2.2）与收缩压呈负相关（均P<0.05）。身长标准差评分的出生后变化与收缩压无显著关联。出生身长标准差评分与30岁时的舒张压呈负相关（β=-2.6；P<0.05）。其他人体测量变量与舒张压无关。研究结果支持以下假设：胎儿生长和出生后早期生长都可能对成年人血压产生长期影响。这也凸显了区分身长和身长体重的重要性。
