Risnes Kari R, Nilsen Tom I L, Romundstad Pål R, Vatten Lars J
Department of Public Health, Medical Research Centre, Norwegian University of Science and Technology, Trondheim, Norway.
Int J Epidemiol. 2009 Aug;38(4):955-62. doi: 10.1093/ije/dyp169. Epub 2009 Apr 7.
Many studies have shown that low birthweight is associated with increased risk of heart disease in adulthood. It is controversial whether this association is caused by genetic or non-genetic factors, and whether life course exposures, such as adult overweight, could modify the association. We have studied the association of head circumference at birth with later deaths from coronary heart disease (CHD), and assessed whether maternal height and adult body mass could modify the association.
Population-based cohort study of 35,846 men and women born between 1920 and 1959 with mortality follow-up from 1961 to 2005.
During follow-up, 630 people died from CHD and there was an inverse association of head circumference with deaths from CHD (Ptrend = 0.010). The association was modified by maternal height (Pinteraction = 0.01) and by adult body mass (Pinteraction = 0.05). People in the lowest third of head circumference, who had a tall mother or a high body mass index in adulthood, were at the highest risk of death from CHD.
Head circumference at birth was inversely associated with deaths from CHD, and the combination of small head and tall mother, or small head and high adult body mass, was associated with the highest risk. These findings suggest that combined effects of genetic factors (growth potential and intrauterine growth) and non-genetic factors acting throughout the life course (intrauterine growth restriction and later weight gain) could mediate the effects of birth size on adult heart disease.
许多研究表明，低出生体重与成年后患心脏病的风险增加有关。这种关联是由遗传因素还是非遗传因素引起的，以及诸如成人超重等生命历程暴露因素是否会改变这种关联，目前仍存在争议。我们研究了出生时头围与后来冠心病（CHD）死亡之间的关联，并评估了母亲身高和成人体重是否会改变这种关联。
对1920年至1959年间出生的35846名男性和女性进行基于人群的队列研究，随访时间为1961年至2005年。
在随访期间，630人死于冠心病，头围与冠心病死亡呈负相关（Ptrend = 0.010）。这种关联受到母亲身高（P交互作用 = 0.01）和成人体重（P交互作用 = 0.05）的影响。头围处于最低三分位数的人群，如果其母亲身高较高或成年后体重指数较高，则死于冠心病的风险最高。
出生时头围与冠心病死亡呈负相关，小头围与高母亲身高或小头围与高成人体重的组合与最高风险相关。这些发现表明，遗传因素（生长潜力和子宫内生长）和贯穿生命历程的非遗传因素（子宫内生长受限和后期体重增加）的综合作用可能介导出生大小对成人心脏病的影响。
