Ohlsson Claes, Bygdell Maria, Sondén Arvid, Jern Christina, Rosengren Annika, Kindblom Jenny M
From the Centre for Bone and Arthritis Research, Institute of Medicine (C.O., M.B., J.M.K.), Bioinformatics Core Facility (A.S.), Institute of Biomedicine (C.J.), and Department of Molecular and Clinical Medicine (A.R.), the Sahlgrenska Academy at University of Gothenburg, Sweden.
Neurology. 2017 Jul 25;89(4):363-369. doi: 10.1212/WNL.0000000000004158. Epub 2017 Jun 28.
OBJECTIVE: To evaluate the contribution of prepubertal childhood body mass index (BMI) and BMI change through puberty and adolescence, 2 distinct developmental BMI parameters, for risk of adult stroke in men. METHODS: In this population-based study in Gothenburg, Sweden, men born in 1945-1961 with information on both childhood BMI at age 8 and BMI change through puberty and adolescence (BMI at age 20-BMI at age 8) were followed until December 2013 (n = 37,669). Information on stroke events was retrieved from high-quality national registers (918 first stroke events, 672 ischemic stroke events [IS], 207 intracerebral hemorrhage events [ICH]). RESULTS: BMI increase through puberty and adolescence (hazard ratio [HR] 1.21 per SD increase; 95% confidence interval [CI] 1.14-1.28), but not childhood BMI, was independently associated with risk of adult stroke. Subanalyses revealed that BMI increase through puberty and adolescence was associated with both IS (HR per SD increase 1.19; 95% CI 1.11-1.28) and ICH (HR per SD increase 1.29; 95% CI 1.15-1.46). High BMI increase during puberty was strongly associated with increased risk of adult hypertension (odds ratio per SD increase 1.35; 95% CI 1.32-1.39). CONCLUSIONS: BMI increase through puberty and adolescence is associated with risk of adult IS and ICH in men. We propose that greater BMI increases during puberty contribute to increased risk of adult stroke at least partly via increased blood pressure.
目的：评估青春期前儿童体重指数（BMI）以及贯穿青春期和青少年期的BMI变化（两个不同的发育BMI参数）对男性成年后中风风险的影响。 方法：在瑞典哥德堡进行的这项基于人群的研究中，对1945年至1961年出生且有8岁时儿童BMI以及青春期和青少年期BMI变化（20岁时的BMI减去8岁时的BMI）信息的男性进行随访，直至2013年12月（n = 37,669）。中风事件信息从高质量的国家登记处获取（918例首次中风事件，672例缺血性中风事件[IS]，207例脑出血事件[ICH]）。 结果：青春期和青少年期BMI的增加（每标准差增加的风险比[HR]为1.21；95%置信区间[CI]为1.14 - 1.28），而非儿童期BMI，与成年后中风风险独立相关。亚组分析显示，青春期和青少年期BMI的增加与IS（每标准差增加的HR为1.19；95%CI为1.11 - 1.28）和ICH（每标准差增加的HR为1.29；95%CI为1.15 - 1.46）均相关。青春期BMI大幅增加与成年后高血压风险增加密切相关（每标准差增加的比值比为1.35；95%CI为1.32 - 1.39）。 结论：青春期和青少年期BMI的增加与男性成年后IS和ICH的风险相关。我们提出，青春期BMI的更大增加至少部分通过血压升高导致成年后中风风险增加。
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