Endocrinology Unit, Division of Paediatrics, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Clin Endocrinol (Oxf). 2012 May;76(5):713-8. doi: 10.1111/j.1365-2265.2011.04308.x.
Low birth weight has been independently associated with adult hypertension, and renin-angiotensin system (RAS) plays a role in this connection.
To characterize the associations between birth weight (BW) and serum aldosterone (SA), serum cortisol, plasma renin activity (PRA) and blood pressure (BP).
Cross-sectional study.
Children from the community born at a gestational age >32 weeks.
Systolic and diastolic BP indices (SBPi and DBPi) were calculated using the observed BP/50th percentile BP for gender, age and stature. BW was transformed to a standard deviation score (SDS) for gestational age, whereas SA, serum cortisol and PRA were transformed using the natural log.
We selected 288 subjects between the ages of 4·9 and 15·5 years (Females, 50%). After adjusting for body mass index (BMI) SDS and Tanner, multiple regression analysis revealed that BW (SDS) was both independently and inversely associated with the natural log of SA (β = -0·065; P = 0·039), the natural log of serum cortisol (β = -0·064; P = 0·009), SBPi (β = -0·012; P = 0·020) and DBPi (β = -0·023; P = 0·002). An association was not observed with PRA (P = 0·178) and aldosterone renin ratio (ARR) (P = 0·452). Serum cortisol levels were positively associated with SA (r = 0·125; P = 0·034), while an association with PRA (P = 0·251) and ARR (P = 0·052) was not observed.
The results of this study demonstrate an inverse association between birth weight and blood pressure and serum aldosterone and cortisol levels. This association is independent of BMI and Tanner, suggesting foetal programming of the hypothalamic-pituitary-adrenal axis.
低出生体重与成人高血压独立相关，肾素-血管紧张素系统（RAS）在这方面发挥作用。
描述出生体重（BW）与血清醛固酮（SA）、血清皮质醇、血浆肾素活性（PRA）和血压（BP）之间的关系。
横断面研究。
社区中胎龄大于 32 周的出生儿童。
使用性别、年龄和身高的观察 BP/50 百分位 BP 计算收缩压指数（SBPi）和舒张压指数（DBPi）。BW 转化为胎龄的标准差评分（SDS），而 SA、血清皮质醇和 PRA 则使用自然对数进行转换。
我们选择了年龄在 4.9 至 15.5 岁之间的 288 名受试者（女性占 50%）。在校正体重指数（BMI）SDS 和 Tanner 后，多元回归分析显示，BW（SDS）与 SA 的自然对数（β=-0.065；P=0.039）、血清皮质醇的自然对数（β=-0.064；P=0.009）、SBPi（β=-0.012；P=0.020）和 DBPi（β=-0.023；P=0.002）均呈负相关。与 PRA（P=0.178）和醛固酮肾素比（ARR）（P=0.452）无相关性。血清皮质醇水平与 SA 呈正相关（r=0.125；P=0.034），而与 PRA（P=0.251）和 ARR（P=0.052）无相关性。
本研究结果表明，出生体重与血压以及血清醛固酮和皮质醇水平呈负相关。这种相关性独立于 BMI 和 Tanner，表明下丘脑-垂体-肾上腺轴的胎儿编程。
