Department of Social Medicine, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK.
J Epidemiol Community Health. 2012 Jan;66(1):18-23. doi: 10.1136/jech.2009.104216. Epub 2010 Aug 24.
Taller adults have a reduced risk of cardiovascular disease, and there is some evidence that pre-adolescent exposures, indexed by leg length, underlie this association. Associations with other aspects of skeletal size in childhood have not previously been investigated.
We have examined associations of cardiovascular mortality and morbidity with childhood height, shoulder breadth, leg, trunk and foot length using a cohort of children whose families participated in a 1937-9 survey of diet and health followed up for 59 years.
Altogether 2642 traced participants had at least one anthropometric measurement; a subsample (n=1043), completed the Rose angina questionnaire and provided information about doctor-diagnosed ischaemic heart disease (IHD) in 1997-8. Childhood stature was weakly inversely associated with cardiovascular mortality, and leg length was the component with the strongest associations. There was evidence from secondary analyses that childhood anthropometric measurements were inversely related to early (age <65 years) rather than late cardiovascular mortality. Childhood stature was inversely associated with self-reported IHD and associations with leg length were strongest. Associations were somewhat attenuated in models including terms for having been breastfed and socioeconomic position.
Pre-adult exposures are more strongly associated with cardiovascular morbidity than mortality, and they affect premature cardiovascular mortality more than later mortality.
身材较高的成年人患心血管疾病的风险较低,有一些证据表明,青春期前的暴露(以腿长为指标)是导致这种关联的原因。然而,儿童时期骨骼大小的其他方面与心血管疾病的关联尚未得到研究。
我们研究了心血管疾病死亡率和发病率与儿童身高、肩宽、腿长、躯干长和足长的关系,该队列中的儿童及其家庭参加了 1937-1939 年的一项饮食与健康调查,并进行了 59 年的随访。
共有 2642 名可追踪参与者至少进行了一次人体测量;其中一个亚组(n=1043)在 1997-1998 年完成了 Rose 心绞痛问卷,并提供了有关医生诊断的缺血性心脏病(IHD)的信息。儿童身高与心血管疾病死亡率呈弱负相关,而腿长与心血管疾病死亡率的相关性最强。二次分析的结果表明,儿童期的人体测量指标与早期(年龄<65 岁)而非晚期心血管疾病死亡率呈负相关。儿童身高与自我报告的 IHD 呈负相关,而与腿长的相关性最强。在包括母乳喂养和社会经济地位因素的模型中,相关性有所减弱。
成年前的暴露与心血管疾病的发病率比死亡率更相关,并且它们对早发性心血管疾病死亡率的影响大于对晚发性死亡率的影响。