Subdivision of Endocrinology, Department of Pediatrics, Erasmus MC/Sophia Children's Hospital, Rotterdam, The Netherlands.
Horm Res Paediatr. 2012;77(6):394-401. doi: 10.1159/000338791.
To investigate the effect of birth size and weight gain during childhood on blood pressure and carotid intima-media thickness (cIMT) in young adulthood.
The relationship of birth size with systolic blood pressure (SBP), diastolic blood pressure (DBP), and cIMT was investigated in 243 adults, aged 18–24 years. SBP, DBP, and cIMT were also analyzed in 4 subgroups: subjects either born small for gestational age with short stature (SGA-S) or with catch-up growth (SGA-CU), or born appropriate for gestational age with idiopathic short stature or with normal stature (controls).
Adult weight SDS and fat mass were positively related to SBP and DBP, adjusted for birthweight SDS which was not related to SBP and DBP. Birth size was also not related to cIMT. Subgroup analyses showed no differences in blood pressure between subgroups, but cIMT was significantly greater in SGA-CU subjects than in controls after correction for age, gender and artery diameter. This difference became borderline significant after additional correction for smoking and SBP.
Not birth size but childhood weight gain, especially fat mass, determines young adult blood pressure. Postnatal catch-up growth appears to have a greater influence on cardiovascular disease markers than birth size.
研究儿童期出生体重和体重增加对青年期血压和颈动脉内膜中层厚度（cIMT）的影响。
在 243 名年龄在 18-24 岁的成年人中，调查了出生体重与收缩压（SBP）、舒张压（DBP）和 cIMT 的关系。还在 4 个亚组中分析了 SBP、DBP 和 cIMT：出生时体重小于胎龄且身材矮小（SGA-S）或有追赶生长（SGA-CU）的受试者，或出生时体重适足但有特发性身材矮小或正常身材的受试者（对照组）。
成人体重 SDS 和脂肪量与 SBP 和 DBP 呈正相关，调整了与 SBP 和 DBP 无关的出生体重 SDS。出生体重也与 cIMT 无关。亚组分析显示，亚组间血压无差异，但在校正年龄、性别和动脉直径后，SGA-CU 组的 cIMT 明显大于对照组。在进一步校正吸烟和 SBP 后，这一差异具有边缘显著性。
不是出生体重，而是儿童期体重增加，特别是脂肪量，决定了青年期的血压。出生后追赶生长对心血管疾病标志物的影响似乎大于出生体重。
