Painter Rebecca C, de Rooij Susanne R, Bossuyt Patrick M, de Groot Eric, Stok Wim J, Osmond Clive, Barker David J, Bleker Otto P, Roseboom Tessa J
Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
J Hypertens. 2007 Mar;25(3):533-40. doi: 10.1097/HJH.0b013e328012135b.
Experimental evidence indicates that maternal undernutrition during gestation may program hypertension in the offspring. We investigated whether maternal undernutrition leads to increased arterial stiffness.
We measured carotid artery lumen diameter (LD), distensibility (DC), stiffness (beta), and compliance (CC) by M-mode ultrasound in 673 individuals, aged 56-61 years, who had been born as term singletons around the time of the 1944-45 Dutch famine.
Maternal famine exposure had no effect on any of the measures of carotid size or stiffness in the offspring. Low maternal weight at the end of pregnancy and low birth weight were associated with decreased LD (0.01 mm/kg maternal weight, sex-adjusted P < 0.001; 0.1 mm/kg birth weight, sex-adjusted P = 0.08) and CC (0.002 mm2/kPa per kg maternal weight, sex-adjusted P = 0.001; 0.03 mm2/kPa per kg birth weight, sex-adjusted P = 0.03), but neither was associated with increased beta, or decreased DC. These effects were not attenuated by adjusting for maternal protein/carbohydrate ratio in the third trimester. The association of low birth weight with increased CC diminished after adjusting for maternal weight. The association of maternal weight with CC was smaller when adjusted for LD.
Our findings suggest that small maternal size, not poor maternal diet, in late gestation programs decreased arterial compliance in the adult offspring by affecting vessel size rather than vessel wall stiffness.
实验证据表明,孕期母亲营养不足可能会使后代患高血压。我们调查了母亲营养不足是否会导致动脉僵硬度增加。
我们通过M型超声测量了673名年龄在56 - 61岁之间、在1944 - 1945年荷兰饥荒时期足月单胎出生的个体的颈动脉管腔直径(LD)、扩张性(DC)、僵硬度(β)和顺应性(CC)。
母亲饥荒暴露对后代颈动脉大小或僵硬度的任何测量指标均无影响。妊娠末期母亲体重低和出生体重低与LD降低(每千克母亲体重降低0.01毫米,经性别调整P < 0.001;每千克出生体重降低0.1毫米,经性别调整P = 0.08)和CC降低(每千克母亲体重降低0.002平方毫米/千帕,经性别调整P = 0.001;每千克出生体重降低0.03平方毫米/千帕,经性别调整P = 0.03)相关,但均与β增加或DC降低无关。通过调整孕晚期母亲蛋白质/碳水化合物比例,这些影响并未减弱。调整母亲体重后,低出生体重与CC增加之间的关联减弱。调整LD后,母亲体重与CC之间的关联变小。
我们的研究结果表明,妊娠晚期母亲身材矮小而非母亲饮食不良,通过影响血管大小而非血管壁僵硬度,使成年后代的动脉顺应性降低。