多民族儿童的出生体重与心脏代谢风险模式。
Birthweight and cardiometabolic risk patterns in multiracial children.
机构信息
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Int J Obes (Lond). 2018 Jan;42(1):20-27. doi: 10.1038/ijo.2017.196. Epub 2017 Aug 14.
BACKGROUND/OBJECTIVES: Prenatal growth, which is widely marked by birthweight, may have a pivotal role in affecting the lifelong risk of cardiometabolic disorders; however, comprehensive evaluation of its relations with childhood cardiometabolic risk patterns and the ethnic and gender disparities in national representative populations is still lacking. The aim of this study was to evaluate the associations between birthweight and comprehensive patterns of cardiometabolic risk in a nationally representative sample of children and adolescents.
SUBJECTS/METHODS: Prospective analyses were performed using data from 28 153 children 0 to 15 years in the National Health and Nutrition Examination Survey from 1999 through 2014. We defined childhood cardiometabolic disorders using standard definitions for obesity, high blood pressure, hyperglycemia and dyslipidemia.
RESULTS
Five birthweight categories <2.5, 2.5-3.0, 3.0-3.5, 3.5-4.2 and ⩾4.2 kg accounted for 8.2%, 17.9%, 35.7%, 27.9% and 10.4% of the population, respectively. In all children, with increasing birthweight, we observed significantly increasing trends of the risk of general and central obesity (P for trend <0.01) and significantly decreasing trends of the risk of high systolic blood pressure (SBP), high HbA1c and low high-density lipoprotein cholesterol (HDL-C) (P for trend <0.05). The associations were independent of current body mass index (BMI). In addition, we found that the relations of birthweight with high waist circumference in Black children showed U-shape, as well as high SBP in Mexican and Hispanic children. Moreover, we found that the associations of low birthweight with high SBP and low HDL-C appeared to more prominent significant in boys, whereas the inverse association with high HbA1c was more evident in girls.
CONCLUSIONS
Our data indicate that birthweight is significantly related to childhood cardiometabolic risk, independent of current BMI, and the associations exhibit race and gender-specific patterns.
背景/目的：产前生长（通常以出生体重为标志）可能在很大程度上影响终生患心血管代谢疾病的风险；然而，在具有代表性的全国性人群中，对于其与儿童心血管代谢风险模式的关系以及种族和性别差异，仍缺乏全面的评估。本研究旨在评估出生体重与全国代表性儿童和青少年心血管代谢风险综合模式之间的关系。
受试者/方法：使用 1999 年至 2014 年全国健康和营养检查调查中 0 至 15 岁的 28153 名儿童的数据进行前瞻性分析。我们使用肥胖、高血压、高血糖和血脂异常的标准定义来定义儿童期心血管代谢疾病。
结果
体重不足 2.5kg、2.5-3.0kg、3.0-3.5kg、3.5-4.2kg 和 ⩾4.2kg 的五个出生体重类别分别占人群的 8.2%、17.9%、35.7%、27.9%和 10.4%。在所有儿童中，随着出生体重的增加，我们观察到一般和中心性肥胖的风险呈显著增加趋势（趋势 P<0.01），而收缩压（SBP）高、糖化血红蛋白（HbA1c）高和高密度脂蛋白胆固醇（HDL-C）低的风险呈显著降低趋势（趋势 P<0.05）。这些关联与当前的体重指数（BMI）无关。此外，我们发现黑种儿童中出生体重与高腰围的关系呈 U 形，墨西哥裔和西班牙裔儿童中 SBP 升高。此外，我们发现低出生体重与 SBP 升高和 HDL-C 降低的关联在男孩中似乎更为显著，而与 HbA1c 降低的关联在女孩中更为明显。
结论
我们的数据表明，出生体重与儿童期心血管代谢风险显著相关，与当前 BMI 无关，且关联存在种族和性别特异性模式。
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