Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Sci Rep. 2018 Jun 25;8(1):9632. doi: 10.1038/s41598-018-27815-1.
Children born small for gestational age (SGA) are more likely to develop high blood pressure. In prior studies, longer sleep duration is associated with lower BP, and SGA is associated with shorter sleep duration in childhood. We investigated whether sleep duration in early childhood modifies the association between SGA and higher childhood SBP in 1178 children recruited at birth and followed up to age 9 years. We ascertained birthweight and gestational age from medical records. We derived child sleep duration from maternal questionnaire interview. We calculated child SBP percentile according to U.S. reference data. We defined elevated SBP as SBP ≥75 percentile. In this sample, 154 (13.1%) children were born SGA. Children born SGA had higher SBP percentiles and higher risk of elevated SBP. Among children born SGA, those in the highest compared to the lowest tertile for sleep had a 12.28 lower (-22.00, -2.57) SBP percentile and 0.44 (0.25 to 0.79) times lower risk of developing elevated SBP. Our data are consistent with an interaction between SGA and sleep duration on childhood elevated SBP (P = 0.0056). In conclusion, in this prospective birth cohort, longer sleep duration in early childhood may mitigate the blood pressure-raising effect of being born small.
出生体重小于胎龄（SGA）的儿童更有可能发展为高血压。在之前的研究中，睡眠时间较长与血压较低有关，而 SGA 与儿童时期睡眠时间较短有关。我们研究了儿童早期睡眠时间是否会改变 SGA 与儿童期较高收缩压（SBP）之间的关联，研究对象为 1178 名在出生时招募并随访至 9 岁的儿童。我们从病历中确定了出生体重和胎龄。我们从母亲的问卷调查中获得了儿童的睡眠时间。我们根据美国参考数据计算了儿童的 SBP 百分位数。我们将 SBP 升高定义为 SBP≥75 百分位数。在这个样本中，有 154 名（13.1%）儿童出生时为 SGA。出生时为 SGA 的儿童 SBP 百分位数较高，且发生 SBP 升高的风险较高。在出生时为 SGA 的儿童中，与睡眠最短组相比，睡眠最长组的 SBP 百分位数低 12.28（-22.00，-2.57），发生 SBP 升高的风险低 0.44（0.25 至 0.79）。我们的数据与 SGA 和睡眠时间对儿童期 SBP 升高的交互作用一致（P=0.0056）。总之，在这项前瞻性出生队列研究中，儿童早期较长的睡眠时间可能减轻出生时体重较轻对血压升高的影响。
