Helmholtz Zentrum Munich, Center for Environment and Health, Institute of Epidemiology I, Neuherberg, Germany.
J Hypertens. 2012 Jun;30(6):1114-21. doi: 10.1097/HJH.0b013e328352d699.
Rapid growth velocity in early life may be a risk factor for obesity, elevated blood pressure, and adverse metabolic markers in childhood, but results are not consistent. We analysed the association between peak growth velocity during the first 2 years of life and blood pressure, fasting glucose and insulin at 10 years of age.
A prospective German birth cohort (LISAplus) provided data on growth, blood pressure, glucose, and insulin for 1127 children up to the age of 10 years. All children had a birth weight of at least 2500 g. Growth was modelled using nonlinear mixed-effect Reed1 models. Associations between peak growth velocities and metabolic outcomes were calculated with linear regression models. Potential confounders were sequentially adjusted for.
Higher peak height velocity (PHV) and peak weight velocity (PWV) in infancy were associated with significant increase in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in children at 10 years. For each 10.2 cm/year [2 standard deviation (SD)] increase in PHV, SBP increased by 2.94 mmHg [95% confidence interval (CI) 1.34, 4.54] after adjustment for potential confounders including birth weight and body mass index. A 5.1 kg/year (2 SD) higher PWV was associated with a 2.13 mmHg (95% CI 0.51, 3.74) increase in SBP and a 1.91 mmHg (95% CI 0.52, 3.30) increase in DBP. No consistent associations were found between PHV or PWV and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index after multiple adjustments.
Blood pressure and metabolic outcomes at school age may be associated with growth patterns in early life, regardless of relative weight during school age.
生命早期的快速生长速度可能是儿童期肥胖、血压升高和代谢标志物异常的危险因素,但结果并不一致。我们分析了生命最初 2 年内的生长高峰期与 10 岁时血压、空腹血糖和胰岛素之间的关系。
一项前瞻性德国出生队列(LISAplus)为 1127 名儿童提供了生长、血压、血糖和胰岛素的数据,这些儿童的出生体重至少为 2500g。使用非线性混合效应 Reed1 模型对生长进行建模。使用线性回归模型计算生长高峰期速度与代谢结果之间的关联。依次调整潜在混杂因素。
婴儿期较高的身高生长速度峰值(PHV)和体重生长速度峰值(PWV)与儿童 10 岁时的收缩压(SBP)和舒张压(DBP)显著升高相关。在调整了潜在混杂因素(包括出生体重和体重指数)后,PHV 每增加 10.2cm/年(2 个标准差),SBP 增加 2.94mmHg(95%置信区间 1.34,4.54)。PWV 每增加 5.1kg/年(2 个标准差),SBP 增加 2.13mmHg(95%置信区间 0.51,3.74),DBP 增加 1.91mmHg(95%置信区间 0.52,3.30)。在多次调整后,PHV 或 PWV 与稳态模型评估的胰岛素抵抗指数(HOMA-IR)之间没有一致的关联。
无论学龄期的相对体重如何,儿童期的血压和代谢结果可能与生命早期的生长模式有关。