Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, 30 Guilford Street London WC1N 1EH, UK.
Eur Heart J. 2013 Apr;34(16):1215-24. doi: 10.1093/eurheartj/ehs333. Epub 2012 Dec 12.
Improvement in lipid profiles is an important public health and clinical goal for which a better understanding is needed of biological pathways and influences. Evidence is scant on the role of growth, including trajectories of body mass index (BMI), so we aimed to determine whether particular life stages from birth to adulthood are important for lipid levels in mid-adulthood (45 years).
In the 1958 British birth cohort (n = 3927 men; 3897 women), weight and height were recorded at: birth (weight only), 7, 11, 16, 23, 33, and 45 years. Birthweight was inversely associated with triglycerides and in women with total- and non-high-density lipoprotein cholesterol; associations were little affected by adjustment for 7-year BMI. Associations between lipids and BMI strengthened with age, e.g. in women, adult (45-year) triglycerides were elevated by 1.54% (95% confidence interval: 0.87-2.21%) and 3.57% (3.29-3.86%), respectively, per kg/m² higher BMI at 11 and 45 years. Body mass index gain was related to lipids, with strongest associations for the interval between 33 and 45 years, where a kg/m² gain in BMI was associated with ~0.6% higher total cholesterol and ~5.3% higher triglycerides. Associations between 45-year BMI and lipids were stronger for those with lowest than highest BMI at younger ages (P for interaction ≤0.05). A long duration of obesity and obesity in childhood but not thereafter were unrelated to adult lipid levels.
Our findings from a large population-based cohort highlight detrimental consequences of high adult BMI for lipids as most pronounced for those with a lower BMI at earlier life stages.
改善血脂谱是公共卫生和临床的重要目标，为此需要更好地了解生物学途径和影响因素。关于生长的作用（包括体重指数（BMI）的轨迹）的证据很少，因此我们旨在确定从出生到成年的特定生命阶段对于中年（45 岁）的血脂水平是否重要。
在 1958 年英国出生队列中（n = 3927 名男性；3897 名女性），体重和身高记录在：出生时（仅体重）、7 岁、11 岁、16 岁、23 岁、33 岁和 45 岁。出生体重与甘油三酯呈负相关，与女性的总胆固醇和非高密度脂蛋白胆固醇呈负相关；这些关联在调整 7 岁 BMI 后几乎没有受到影响。脂质与 BMI 之间的关联随着年龄的增长而增强，例如，在女性中，成人（45 岁）甘油三酯分别升高 1.54%（95%置信区间：0.87-2.21%）和 3.57%（3.29-3.86%），分别为 11 岁和 45 岁时 BMI 每增加 1kg/m²。体重指数增加与脂质有关，33 岁至 45 岁之间的关联最强，BMI 每增加 1kg/m²，总胆固醇升高约 0.6%，甘油三酯升高约 5.3%。45 岁 BMI 与脂质之间的关联在年轻时 BMI 最低的人群中比最高的人群更强（P 交互作用≤0.05）。肥胖持续时间长和儿童期肥胖与成人血脂水平无关。
我们从一个大型基于人群的队列中获得的发现强调了成人 BMI 升高对脂质的不利后果，对于生命早期 BMI 较低的人群最为明显。
