Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand.
Int J Obes (Lond). 2017 Sep;41(9):1355-1360. doi: 10.1038/ijo.2017.108. Epub 2017 May 3.
BACKGROUND/OBJECTIVES: Endothelial dysfunction predicts mortality but it is unknown whether childhood obesity predicts adult endothelial dysfunction. The aim of this study was to determine whether anthropometric indices of body fat in childhood, adolescence and early midlife are associated with endothelial dysfunction in early midlife.
SUBJECTS/METHODS: Participants belonged to a representative birth cohort of 1037 individuals born in Dunedin, New Zealand in 1972 and 1973 and followed to age 38 years, with 95% retention (the Dunedin Multidisciplinary Health and Development Study). We assessed anthropometric indices of obesity at ages 3, 5, 7, 9, 11, 13, 15, 18, 21, 26, 32 and 38 years. We tested associations between endothelial function assessed by peripheral arterial tonometry (PAT) at age 38 and; age 38 cardiovascular risk factors; age 3 body mass index (BMI); and four BMI trajectory groups from childhood to early midlife.
Early midlife endothelial dysfunction was associated with BMI, large waist circumference, low high-density lipoprotein cholesterol, low cardiorespiratory fitness and increased high-sensitivity C-reactive protein. After adjustment for sex and childhood socioeconomic status, 3-year-olds with BMI 1 s.d. above the mean had Framingham-reactive hyperemia index (F-RHI) ratios that were 0.10 below those with normal BMI (β=-0.10, 95% confidence interval (CI) -0.17 to -0.03, P=0.007) at age 38. Cohort members in the 'overweight', 'obese' and 'morbidly obese' trajectories had F-RHI ratios that were 0.08 (β=-0.08, 95% CI -0.14 to -0.03, P=0.003), 0.13 (β=-0.13, 95% CI -0.21 to -0.06, P<0.001) and 0.17 (β=-0.17, 95% CI -0.33 to -0.01, P=0.033), respectively, below age-peers in the 'normal' trajectory.
Childhood BMI and the trajectories of BMI from childhood to early midlife predict endothelial dysfunction evaluated by PAT in early midlife.
背景/目的：内皮功能障碍可预测死亡率，但尚不清楚儿童肥胖是否可预测成人的内皮功能障碍。本研究旨在确定儿童期、青春期和中年早期的身体脂肪人体测量指数是否与中年早期的内皮功能障碍相关。
受试者/方法：参与者属于新西兰达尼丁的代表性出生队列，共有 1972 年和 1973 年出生的 1037 人，随访至 38 岁，保留率为 95%（达尼丁多学科健康和发展研究）。我们在 3、5、7、9、11、13、15、18、21、26、32 和 38 岁时评估肥胖的人体测量指数。我们通过外周动脉张力测定（PAT）评估 38 岁时的内皮功能，并将其与 38 岁时的心血管危险因素、3 岁时的 BMI 以及从儿童期到中年早期的四个 BMI 轨迹组进行关联分析。
中年早期的内皮功能障碍与 BMI、大腰围、低高密度脂蛋白胆固醇、低心肺适能和高敏 C 反应蛋白升高有关。在校正性别和儿童期社会经济地位后，3 岁时 BMI 高于平均值 1 个标准差的个体的 Framingham 反应性充血指数（F-RHI）比值比 BMI 正常的个体低 0.10（β=-0.10，95%置信区间（CI）-0.17 至 -0.03，P=0.007）。处于“超重”、“肥胖”和“病态肥胖”轨迹的队列成员的 F-RHI 比值分别低 0.08（β=-0.08，95%CI-0.14 至 -0.03，P=0.003）、0.13（β=-0.13，95%CI-0.21 至 -0.06，P<0.001）和 0.17（β=-0.17，95%CI-0.33 至 -0.01，P=0.033），低于“正常”轨迹的同年龄组。
儿童期 BMI 及儿童期至中年早期的 BMI 轨迹可预测中年早期通过 PAT 评估的内皮功能障碍。
