Department of Preventive Medicine, Complejo Hospitalario de Navarra, Pamplona, Spain; University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine-Clínica Universidad de Navarra, Pamplona, Spain.
University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine-Clínica Universidad de Navarra, Pamplona, Spain; Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
Nutr Metab Cardiovasc Dis. 2019 Mar;29(3):244-253. doi: 10.1016/j.numecd.2018.12.004. Epub 2018 Dec 21.
Our aim was to assess the association between trajectories of body-shape across the first 40 years of life and subsequent development of hypertension in a Mediterranean cohort.
We used a group-based modeling approach to assess body shape trajectories from age 5 to 40 years, among 7514 participants included in the SUN study (1999-2016), and assessed the subsequent incidence of hypertension. To create the trajectories, we used a censored normal model as a polynomial function of age. Cox models were used to estimates hazard ratios (HR) for hypertension according to body shape trajectories. Identified trajectories were "childhood lean -mid-life increase", "childhood medium-mid-life stable", " childhood heavy -mid-life decrease", and "childhood heavy -mid-life increase" for women; and "childhood lean-mid-life increase", "childhood medium-mid-life stable", "childhood medium -mid-life increase" and "childhood heavy-mid-life stable" for men. After a follow-up of 63,068 person-years, 865 incident cases of hypertension were found. Among women, compared to those in the "childhood medium-mid-life stable" trajectory, those, in the "childhood heavy -mid-life increase" trajectory showed higher risk to develop hypertension [HR = 1.72 (1.17-2.53)]. In men, compared with those in the "childhood medium-mid-life stable" trajectory, those in the "childhood lean and childhood medium -mid-life increase" and the "childhood heavy- mid-life stable" trajectories showed higher subsequent incidence of hypertension [HR = 1.43 (1.11-1.85), HR = 1.52 (1.17-1.97) and HR = 1.56 (1.14-2.14), respectively] after adjusting for potential confounders (including age, lifestyles, dietary intake, personality traits, physical activity and sedentary behaviors).
Our results suggest that mid-life increases in body shape or maintaining a heavy body shape during early and middle life in men and childhood heavy-mid-life increase in women is associated with a higher subsequent risk of developing hypertension in this Mediterranean population.
本研究旨在评估在一个地中海队列中，个体 5 岁至 40 岁期间体廓轨迹与后续高血压发生之间的相关性。
我们采用基于群组的建模方法，对 7514 名参加 SUN 研究（1999-2016 年）的参与者从 5 岁到 40 岁期间的体廓轨迹进行评估，并评估了高血压的后续发病率。为了创建轨迹，我们使用了作为年龄多项式函数的截尾正态模型。Cox 模型用于根据体廓轨迹估计高血压的风险比（HR）。确定的轨迹为女性的“儿童期瘦-中年期增加”、“儿童期中-中年期稳定”、“儿童期重-中年期减少”和“儿童期重-中年期增加”；以及男性的“儿童期瘦-中年期增加”、“儿童期中-中年期稳定”、“儿童期中-中年期增加”和“儿童期重-中年期稳定”。在 63068 人年的随访后，发现了 865 例高血压事件。在女性中，与“儿童期中-中年期稳定”轨迹相比，“儿童期重-中年期增加”轨迹的女性发展为高血压的风险更高[风险比（HR）=1.72（1.17-2.53）]。在男性中，与“儿童期中-中年期稳定”轨迹相比，“儿童期瘦和儿童期中-中年期增加”以及“儿童期重-中年期稳定”轨迹的男性高血压发生风险更高[HR=1.43（1.11-1.85），HR=1.52（1.17-1.97）和 HR=1.56（1.14-2.14）]，调整了潜在混杂因素（包括年龄、生活方式、饮食摄入、人格特质、身体活动和久坐行为）后。
我们的研究结果表明，男性在中年时期体廓增加或在中年时期保持较重的体廓，以及女性儿童期到中年期体重增加，与该地中海人群高血压发生风险的增加相关。
