Unit for Nutrition Research, University of Iceland and Landspitali University Hospital, Reykjavik, Iceland.
Hypertension. 2011 Jul;58(1):8-15. doi: 10.1161/HYPERTENSIONAHA.111.170985. Epub 2011 May 16.
Low birth weight has consistently been associated with increased adult blood pressure. The relative importance of childhood growth is, however, less well established. This study examined sex-specific associations between childhood growth and adult blood pressure in 2120 subjects born from 1921 to 1935 in Reykjavik who were recruited into a longitudinal study in 1967-1991. Size at birth and growth at regular intervals between 8 and 13 years were collected from national archives. Hypertensive males did not differ from normotensive males at birth but were increasingly taller and of higher body mass index between 8 and 13 years. No differences in adult height were observed between hypertensive and normotensive males. For boys, growth-velocity (change in growth per year) for body mass index and height between 8 to 13 years was positively associated (P<0.05) with adult blood pressure. The association for body mass index-velocity was fully accounted for by concurrent body size, whereas height-velocity was independent of birth weight and concurrent body size. Males in the highest compared with the lowest tertile in the height-velocity distribution had 66% increased risks of hypertension (95% CI: 15% to 139% increased risks of hypertension) corresponding with 5.0 mm Hg increase (95% CI: 1.5 to 8.5 mm Hg increase) and 3.1 mm Hg increase (95% CI: 1.1 to 5.0 mm Hg increase) in systolic and diastolic blood pressures, respectively. Hypertensive females weighed less at birth but did not differ markedly from normotensive girls between 8 and 13 years, and no association was observed for growth-velocity. In conclusion, rapid linear growth between 8 and 13 years predicts elevated adult blood pressure in boys. This association is likely to reflect relatively early onset of puberty among hypertensive males.
出生体重偏低与成人血压升高密切相关。然而，儿童时期生长发育与成人血压之间的关系尚未得到充分证实。本研究在雷克雅未克出生于 1921 年至 1935 年的 2120 名受试者中，检查了儿童时期生长与成年血压之间的性别特异性关联，这些受试者于 1967 年至 1991 年期间被招募到一项纵向研究中。从国家档案中收集了出生时的大小和 8 至 13 岁期间定期生长的数据。与血压正常的男性相比，高血压男性在出生时并无差异，但在 8 至 13 岁之间身高更高，体重指数更高。高血压男性与血压正常男性在成年身高方面无差异。对于男孩，8 至 13 岁期间体重指数和身高的生长速度（每年生长变化）与成人血压呈正相关（P<0.05）。体重指数-速度的关联完全由同期的身体大小解释，而身高-速度与出生体重和同期身体大小无关。与身高-速度分布中最低三分位相比，最高三分位的男性患高血压的风险增加了 66%（95%CI：15%至 139%的高血压风险增加），相应的收缩压和舒张压分别增加了 5.0mmHg（95%CI：1.5 至 8.5mmHg 增加）和 3.1mmHg（95%CI：1.1 至 5.0mmHg 增加）。出生体重较轻的女性患有高血压，但在 8 至 13 岁之间与血压正常的女孩没有明显差异，并且生长速度没有关联。总之，8 至 13 岁期间的快速线性生长可预测男孩成年后血压升高。这种关联可能反映了高血压男性青春期的相对较早开始。
