Schack-Nielsen L, Holst C, Sørensen T I A
Danish Epidemiology Science Centre at the Institute of Preventive Medicine, Copenhagen, Denmark.
Int J Obes Relat Metab Disord. 2002 Dec;26(12):1539-46. doi: 10.1038/sj.ijo.0802166.
To determine the influence on blood pressure of relative weight from birth through adulthood in non-obese and juvenile obese men.
Case-cohort study of obesity in Danish men, identified at age (mean+/-s.d.) 19.8+/-1.6 y at draft board examination, who participated in at least one of two follow-up studies in adulthood (age 36.8+/-6.7 and 47.9+/-6.8 y at first and second follow-up, respectively). Birth weight and weight and height from the age of 7-13 y were collected from school health records.
Three hundred and twenty-seven non-obese men (controls) selected as 0.5% of the draft board population and 285 obese men with body mass index (BMI)> or =31 kg/m(2) at draft board examination.
Systolic and diastolic blood pressure measured twice in adulthood adjusted for current age.
Birth weight was inversely related to systolic blood pressure at first and second follow-up, but only significantly so when adjusted for current BMI (regression coefficients in mmHg per unit Z-score (95% confidence interval (CI))-1.2 (-2.3, -0.1) and -1.6 (-3.1, 0.0)). Change in Z-score from birth weight to BMI at the age of 7 y was significantly positively related to systolic blood pressure, but the relationship weakened by adjustment for current BMI (0.8 (0.1, 1.6) and 0.6 (-0.4, 1.6), respectively). If both birth weight and change until 7 y were included in the same model, their effects were both positive and significant, but they weakened and became not significant when adjusted for current BMI. BMI since the age of 7 y had no significant effect on blood pressure beyond that of current BMI.
In a wide range of adult BMI in men, the birth weight was inversely related to systolic blood pressure, even when controlled for BMI since the age of 7 y. However, the effect may reflect the weight change between birth and 7 y of age. After that age BMI had no additional effect on blood pressure beyond the effect of current BMI.
确定出生至成年期相对体重对非肥胖男性和青少年肥胖男性血压的影响。
对丹麦男性肥胖情况进行病例队列研究,这些男性在征兵体检时年龄(均值±标准差)为19.8±1.6岁,成年后参加了两项随访研究中的至少一项(首次随访时年龄为36.8±6.7岁,第二次随访时年龄为47.9±6.8岁)。从学校健康记录中收集出生体重以及7至13岁时的体重和身高数据。
从征兵体检人群中选取327名非肥胖男性(对照组),占比0.5%,以及285名肥胖男性,他们在征兵体检时体重指数(BMI)≥31kg/m²。
成年期测量两次收缩压和舒张压,并根据当前年龄进行调整。
出生体重与首次和第二次随访时的收缩压呈负相关,但仅在根据当前BMI进行调整后才具有显著相关性(每单位Z评分的毫米汞柱回归系数(95%置信区间)为-1.2(-2.3,-0.1)和-1.6(-3.1,0.0))。从出生体重到7岁时BMI的Z评分变化与收缩压显著正相关,但在根据当前BMI进行调整后这种关系减弱(分别为0.8(0.1,1.6)和0.6(-0.4,1.6))。如果将出生体重和7岁前的变化纳入同一模型,它们的影响均为正向且显著,但在根据当前BMI进行调整后,它们的影响减弱且变得不显著。7岁以后的BMI对血压的影响除当前BMI的影响外无显著作用。
在男性成年BMI的广泛范围内,即使控制了7岁以后的BMI,出生体重仍与收缩压呈负相关。然而,这种影响可能反映了出生至7岁之间的体重变化。7岁以后,BMI对血压的影响除当前BMI的影响外无额外作用。