Gamborg Michael, Byberg Liisa, Rasmussen Finn, Andersen Per Kragh, Baker Jennifer L, Bengtsson Calle, Canoy Dexter, Drøyvold Wenche, Eriksson Johan G, Forsén Tom, Gunnarsdottir Ingibjörg, Järvelin Marjo-Riitta, Koupil Ilona, Lapidus Leif, Nilsen Tom I, Olsen Sjurdur F, Schack-Nielsen Lene, Thorsdottir Inga, Tuomainen Tomi-Pekka, Sørensen Thorkild I A
Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
Am J Epidemiol. 2007 Sep 15;166(6):634-45. doi: 10.1093/aje/kwm042. Epub 2007 Apr 23.
The authors investigated the shape, sex- and age-dependency, and possible confounding of the association between birth weight and systolic blood pressure (SBP) in 197,954 adults from 20 Nordic cohorts (birth years 1910-1987), one of which included 166,249 Swedish male conscripts. Random-effects meta-regression analyses were performed on estimates obtained from age- and sex-stratified analyses within each of the cohorts. There was an inverse association between birth weight and SBP, irrespective of adjustment for concurrent body mass index. The association was linear for males, but for females with a birth weight greater than 4 kg, SBP increased with birth weight (p < 0.01). The association was stronger in the older age groups (p < 0.05), although this could have been a birth cohort effect. The association was stronger among females than among males (p = 0.005) when birth weight was less than or equal to 4 kg. The estimated effect of birth weight on SBP at age 50 years was -1.52 mmHg/kg (95% confidence interval: -2.27, -0.77) in men and -2.80 mmHg/kg (95% confidence interval: -3.85, -1.76) in women. Exclusion of the Swedish conscripts produced nearly identical results. This meta-analysis supports the evidence of an inverse birth weight-SBP association, regardless of adjustment for concurrent body size. It also reveals important heterogeneity in the shape and strength of the association by sex and age.
作者调查了来自20个北欧队列（出生年份1910 - 1987年）的197,954名成年人出生体重与收缩压（SBP）之间关联的形状、性别和年龄依赖性以及可能的混杂因素，其中一个队列包括166,249名瑞典男性应征入伍者。对每个队列内按年龄和性别分层分析得到的估计值进行随机效应元回归分析。出生体重与SBP之间存在负相关，无论是否对同时期体重指数进行调整。男性的这种关联是线性的，但对于出生体重超过4kg的女性，SBP随出生体重增加（p < 0.01）。在年龄较大的组中这种关联更强（p < 0.05），尽管这可能是出生队列效应。当出生体重小于或等于4kg时，女性中的这种关联比男性更强（p = 0.005）。50岁时出生体重对SBP的估计效应在男性中为 - 1.52mmHg/kg（95%置信区间：-2.27，-0.77），在女性中为 - 2.80mmHg/kg（95%置信区间：-3.85，-1.76）。排除瑞典应征入伍者后产生了几乎相同的结果。这项荟萃分析支持了出生体重与SBP负相关的证据，无论是否对同时期体型进行调整。它还揭示了该关联在形状和强度上按性别和年龄存在重要的异质性。
