Gunnarsdottir Ingibjorg, Birgisdottir Bryndis E, Thorsdottir Inga, Gudnason Vilmundur, Benediktsson Rafn
Unit for Nutrition Research, Landspitali-University Hospital, Reykjavik, Iceland.
Am J Clin Nutr. 2002 Dec;76(6):1290-4. doi: 10.1093/ajcn/76.6.1290.
Epidemiologic studies suggest a link between fetal and childhood growth and later coronary artery disease (CAD). The influence of adult body size on the relation between birth size and CAD has not been thoroughly studied.
We investigated the association between birth and adult sizes and CAD within a population with higher birth weight and a lower incidence of and mortality rate from CAD than those seen in other Scandinavian populations.
Fatal or nonfatal CAD was ascertained in 2399 men and 2376 women born in the Greater Reykjavik area between 1914 and 1935. Birth size was obtained from the National Archives. Anthropometric measurements in adults were obtained from the randomized prospective Reykjavik Study.
CAD was inversely related to birth length (P for trend = 0.029) in men but was not significantly related to birth weight or ponderal index (kg/m(3)). In men who were born short (< or = 50.5 cm) and who became tall adults (either 175-180.5 or > 180.5 cm), the odds ratios (95% CI) for CAD were 1.9 (1.1, 3.1) and 2.2 (1.2, 4.0), respectively, when compared with men in the reference group (those born 52.5-54.0 cm long). A U-shaped relation between birth size and CAD was found for women.
Size at birth has an effect on CAD, but the effect is modified by adult body size. This confirms that environmental factors operate in both the prenatal and postnatal periods with regard to the development of CAD. The large birth size seen among Icelanders may explain the lower incidence and mortality rate of CAD in Iceland than are seen in other white populations.
流行病学研究表明，胎儿期和儿童期生长与后期冠状动脉疾病（CAD）之间存在联系。成人体型对出生时体型与CAD之间关系的影响尚未得到充分研究。
我们在一个出生体重较高、CAD发病率和死亡率低于其他斯堪的纳维亚人群的人群中，调查出生时和成年时的体型与CAD之间的关联。
确定了1914年至1935年在大雷克雅未克地区出生的2399名男性和2376名女性中的致命或非致命CAD病例。出生时的体型数据来自国家档案馆。成年人的人体测量数据来自随机前瞻性雷克雅未克研究。
男性中CAD与出生身长呈负相关（趋势P值 = 0.029），但与出生体重或体重指数（kg/m³）无显著相关性。在出生时身材矮小（≤50.5 cm）且成年后身材高大（175 - 180.5 cm或>180.5 cm）的男性中，与参照组（出生身长52.5 - 54.0 cm的男性）相比，CAD的优势比（95%CI）分别为1.9（1.1, 3.1）和2.2（1.2, 4.0）。女性中出生时体型与CAD呈U形关系。
出生时的体型对CAD有影响，但这种影响会因成人体型而改变。这证实了在CAD的发生发展过程中，环境因素在产前和产后阶段均起作用。冰岛人出生时体型较大可能解释了冰岛CAD发病率和死亡率低于其他白人人群的现象。
