Krishnaveni G V, Veena S R, Wills A K, Hill J C, Karat S C, Fall C H D
1Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mandi Mohalla, Mysore, India.
2MRC Epidemiology Resource Centre, Southampton General Hospital, Southampton, UK.
J Dev Orig Health Dis. 2010 Dec;1(6):403-11. doi: 10.1017/S2040174410000498.
Lower birthweight, and rapid childhood weight gain predict elevated cardiovascular risk factors in children. We examined associations between serial, detailed, anthropometric measurements from birth to 9.5 years of age and cardiovascular risk markers in Indian children. Children (n = 663) born at the Holdsworth Memorial Hospital, Mysore, India were measured at birth and 6-12 monthly thereafter. At 9.5 years, 539 (255 boys) underwent a 2-h oral glucose tolerance test, and blood pressure (BP) and fasting lipid concentrations were measured. Insulin resistance was calculated using the HOMA equation. These outcomes were examined in relation to birth measurements and changes in measurements (growth) during infancy (0-2 years), 2-5 years and 5-9.5 years using conditional s.d. scores. Larger current weight, height and skinfold thickness were associated with higher risk markers at 9.5 years (P < 0.05). Lower weight, smaller length and mid-arm circumference at birth were associated with higher fasting glucose concentrations at 9.5 years (P ⩽ 0.01). After adjusting for current weight/height, there were inverse associations between birthweight and/or length and insulin concentrations, HOMA, systolic and diastolic BP and plasma triglycerides (P < 0.05). Increases in conditional weight and height between 0-2, 2-5 and 5-9.5 years were associated with higher insulin concentrations, HOMA and systolic BP. In conclusion, in 9-10-year-old Indian children, as in other studies, cardiovascular risk factors were highest in children who were light or short at birth but heavy or tall at 9 years. Greater infant and childhood weight and height gain were associated with higher risk markers.
低出生体重以及儿童期体重快速增加预示着儿童心血管危险因素升高。我们研究了印度儿童从出生到9.5岁期间连续、详细的人体测量数据与心血管风险标志物之间的关联。在印度迈索尔的霍尔兹沃思纪念医院出生的儿童（n = 663）在出生时进行测量，此后每6 - 12个月测量一次。在9.5岁时，539名儿童（255名男孩）接受了2小时口服葡萄糖耐量试验，并测量了血压（BP）和空腹血脂浓度。使用HOMA方程计算胰岛素抵抗。使用条件标准差分数，将这些结果与出生时的测量数据以及婴儿期（0 - 2岁）、2 - 5岁和5 - 9.5岁期间测量数据的变化（生长情况）进行关联研究。9.5岁时，当前体重、身高和皮褶厚度越大，与风险标志物水平越高相关（P < 0.05）。出生时体重越低、身长越小和上臂围越小，与9.5岁时空腹血糖浓度越高相关（P ⩽ 0.01）。在调整当前体重/身高后，出生体重和/或身长与胰岛素浓度、HOMA、收缩压和舒张压以及血浆甘油三酯之间存在负相关（P < 0.05）。0 - 2岁之间、2 - 5岁之间以及5 - 9.5岁之间条件体重和身高的增加与胰岛素浓度、HOMA和收缩压升高相关。总之，与其他研究一样，在9 - 10岁的印度儿童中，出生时体重轻或身高矮但9岁时体重重或身高高的儿童心血管危险因素最高。婴儿期和儿童期体重和身高增加幅度越大，与风险标志物水平越高相关。
