Primatesta Paola, Falaschetti E, Poulter Neil R
Department of Epidemiology and Public Health, University College London Medical School,Gower Street Campus, 1-19 Torrington Place, London WC1E 6BT, UK.
Hypertension. 2005 Jan;45(1):75-9. doi: 10.1161/01.HYP.0000150037.98835.10. Epub 2004 Nov 29.
Findings of previous reports relating low birth weight with raised blood pressure in childhood and adolescence have been inconsistent. The present study uses cross-sectional data from a series of nationally representative annual surveys--the Health Survey for England--between 1995 and 2002, totaling a sample of 15 629 children aged 5 to 15. A significant negative relationship between birth weight, in quartiles or dichotomized as low (<2.5 kg) and normal (> or =2.5 kg) and systolic blood pressure was apparent. Linear regression analyses confirmed these findings. When current weight was included in the model, the strength of the relationship increased. An interaction term between birth weight and current weight was not significant. A life-course plot for those aged 13 to 15 (n=3900), converting the weight measurements at birth and as a teenager to standard deviation scores to make the regression coefficients comparable, showed the importance of weight gain on blood pressure (1 standard deviation increase in weight from birth to age 13 to 15 was associated with an increase in systolic blood pressure of 0.8 mm Hg). Separating those with low and normal birth weight demonstrated that the increase in weight from birth to adolescence had an effect on blood pressure in both those with low and normal birth weight. Postnatal changes in size have a more important effect on blood pressure in childhood and adolescence than birth weight. Reducing the prevalence of overweight among children may reduce their systolic blood pressure importantly and, particularly among children with lower birth weight, the prevalence of hypertension later in life.
先前有关低出生体重与儿童期及青春期血压升高之间关系的报告结果并不一致。本研究使用了1995年至2002年期间一系列具有全国代表性的年度调查——英格兰健康调查——的横断面数据，样本总数为15629名5至15岁的儿童。出生体重按四分位数划分或分为低体重（<2.5千克）和正常体重（≥2.5千克），与收缩压之间存在显著的负相关关系。线性回归分析证实了这些结果。当将当前体重纳入模型时，这种关系的强度增加。出生体重与当前体重之间的交互项不显著。对13至15岁的人群（n = 3900）绘制的生命历程图，将出生时和青少年时期的体重测量值转换为标准差分数以使回归系数具有可比性，结果显示体重增加对血压的重要性（从出生到13至15岁体重增加1个标准差与收缩压升高0.8毫米汞柱相关）。将低出生体重和正常出生体重的人群分开显示，从出生到青春期体重增加对低出生体重和正常出生体重人群的血压均有影响。出生后体型的变化对儿童期和青春期血压的影响比出生体重更为重要。降低儿童超重的患病率可能会显著降低他们的收缩压，特别是在低出生体重儿童中，还可降低其日后患高血压的患病率。
