Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Department of General Practice and Primary Health Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland.
Am J Kidney Dis. 2018 Jan;71(1):20-26. doi: 10.1053/j.ajkd.2017.06.030. Epub 2017 Aug 23.
According to the Developmental Origins of Health and Disease (DOHaD) hypothesis, several noncommunicable diseases, including hypertension, type 2 diabetes, and coronary heart disease, have their origins in early life. Chronic kidney disease (CKD) has traditionally been assumed to develop as the result of an interaction between genetic and environmental factors, although more recently, the importance of factors present early in life has been recognized.
Longitudinal birth cohort study.
SETTING & PARTICIPANTS: 20,431 people born in 1924 to 1944 in Helsinki, Finland, who were part of the Helsinki Birth Cohort Study were followed up through their life course from birth until death or age 86 years.
Prenatal growth and socioeconomic factors.
Death or hospitalization for CKD.
Smaller body size at birth was associated with increased risk for developing CKD. Each standard deviation higher birth weight was associated with an HR for CKD of 0.82 (95% CI, 0.74-0.91; P<0.001). Associations with ponderal index at birth, placental weight, and birth length were also statistically significant (P<0.001, P<0.001, and P=0.002, respectively), but only among men. Prematurity also predicted increased risk for CKD.
The study was restricted to people who were born in Helsinki in 1924 to 1944.
Smaller body size at birth was associated with increased risk for developing CKD in men. Prematurity was also associated with increased risk for CKD in women. These findings in the Helsinki Birth Cohort Study support the importance of early life factors in the development of CKD.
根据健康与疾病的发育起源（DOHaD）假说，包括高血压、2 型糖尿病和冠心病在内的几种非传染性疾病都起源于生命早期。慢性肾病（CKD）传统上被认为是遗传和环境因素相互作用的结果，尽管最近人们越来越认识到生命早期因素的重要性。
纵向出生队列研究。
芬兰赫尔辛基出生队列研究中 1924 年至 1944 年期间出生的 20431 人，从出生到死亡或 86 岁进行了终生随访。
产前生长和社会经济因素。
出生时体型较小与 CKD 发病风险增加相关。出生体重每增加一个标准差，CKD 的 HR 为 0.82（95%CI，0.74-0.91；P<0.001）。与出生时的体质量指数、胎盘重量和出生时的身长也存在统计学显著关联（P<0.001、P<0.001 和 P=0.002 分别），但仅见于男性。早产也预测 CKD 的风险增加。
该研究仅限于 1924 年至 1944 年期间在赫尔辛基出生的人群。
出生时体型较小与男性发生 CKD 的风险增加相关。早产也与女性 CKD 风险增加相关。这些在赫尔辛基出生队列研究中的发现支持了生命早期因素在 CKD 发展中的重要性。
