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中国儿童的出生体重、产后体重变化与高血压风险。

Birth weight, postnatal weight change, and risk for high blood pressure among chinese children.

机构信息

Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20852, USA.

出版信息

Pediatrics. 2011 May;127(5):e1272-9. doi: 10.1542/peds.2010-2213. Epub 2011 Apr 18.

Abstract

BACKGROUND

It is hypothesized that a physiological predisposition toward hypertension results from a combination of intrauterine growth restriction or overgrowth and excessive postnatal weight gain. Previous studies were conducted largely in Western countries however the hypothesis may also be relevant in developing countries where metabolic disorders are increasing.

OBJECTIVE

We investigated the association of birth weight and postnatal weight gain with hypertension among Chinese children.

METHODS

A population based study was conducted among 15 600 children aged 3 to 6 years from Tianjin, China. Weight was expressed as z scores. Postnatal weight gain was defined as changes in z scores from birth to 3 to younger than 4 years, 4 to younger than 5 years, and 5 to 6 years. Hypertension was defined as greater than the 90th percentile of either systolic or diastolic blood pressure. Logistic regression-derived odds ratios and 95% confidence intervals were generated to estimate the association between birth weight and postnatal weight gain with hypertension risk in childhood.

RESULTS

Birth weight was positively associated with childhood hypertension in boys and girls (odds ratios [95% confidence interval] comparing extreme quartiles [high versus low] were 5.67 [3.83-8.39] and 2.58 [3.83-8.39], respectively). Postnatal weight gain was positively associated with hypertension and the association did not significantly vary by birth size for gestational age.

CONCLUSIONS

Greater birth weight or postnatal weight gain was associated with increased childhood hypertension risk, suggesting that intrauterine growth and postnatal weight gain may have implications on health during childhood.

摘要

背景

有人假设,高血压的生理倾向是宫内生长受限或过度生长以及出生后体重过度增加共同作用的结果。然而,这一假说也可能与代谢紊乱日益增多的发展中国家有关,因为此前的研究主要在西方国家进行。

目的

我们调查了中国儿童的出生体重和出生后体重增加与高血压之间的关系。

方法

在中国天津,对 15600 名 3 至 6 岁的儿童进行了一项基于人群的研究。体重用 z 评分表示。出生后体重增加定义为从出生到 3 岁以下、4 岁以下、5 岁以下到 6 岁期间 z 评分的变化。高血压定义为收缩压或舒张压大于第 90 百分位。采用 logistic 回归分析得出比值比和 95%置信区间,以评估出生体重和出生后体重增加与儿童期高血压风险之间的关系。

结果

出生体重与男孩和女孩的儿童期高血压呈正相关(比较极值四分位数[高与低]的比值比[95%置信区间]分别为 5.67[3.83-8.39]和 2.58[3.83-8.39])。出生后体重增加与高血压呈正相关,且与出生时的胎龄大小无关。

结论

出生体重较大或出生后体重增加与儿童期高血压风险增加有关,这表明宫内生长和出生后体重增加可能对儿童期健康有影响。

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