Center for Human Growth and Development, University of Michigan, Ann Arbor, MI; Department of Pediatrics, University of Michigan, Ann Arbor, MI.
Institute of Child Development, University of Minnesota, Minneapolis, MN.
J Pediatr. 2019 Jun;209:85-91.e1. doi: 10.1016/j.jpeds.2019.01.058. Epub 2019 Mar 12.
To prospectively assess whether the infant psychosocial environment was associated with cardiometabolic risk as early as adolescence.
Participants were recruited in Santiago, Chile, and have been followed from infancy. Inclusion criteria included healthy infants with birth weight ≥3 kg and a stable caregiver. The psychosocial environment, including depressive symptoms, stressful life events, poor support for child development, father absence, and socioeconomic status, was reported by mothers at 6-12 months. Body mass index (BMI) z score was assessed at 5 and 10 years. BMI z score, waist-to-hip ratio, systolic and diastolic blood pressure, fat mass and body fat percentage, fasting glucose, total and high-density lipoprotein cholesterol, and homeostatic model of insulin resistance were tested in adolescence.
Adolescents ranged from 16 to 18 years of age (n = 588; 48.1% female). A poorer infant psychosocial environment was associated with BMI z score at 10 years (β = 0.10, 95% CI = 0.00-0.19) and in adolescence (β = 0.15, 95% CI = 0.06-0.24) but not at 5 years. A poorer infant psychosocial environment was associated with higher blood pressure (β = 0.15, 95% CI = 0.05-0.24), greater anthropometric risk (β = 0.13, 95% CI = 0.03-0.22), greater biomarker (triglycerides, homeostatic model assessment of insulin resistance, total cholesterol) risk (β = 0.12, 95% CI = 0.02-0.22), and a higher likelihood of metabolic syndrome in adolescence (aOR = 1.50; 95% CI = 1.06-2.12).
These findings demonstrate that a poorer infant psychosocial environment was associated with greater adolescent cardiometabolic risk. The results support screening for infants' psychosocial environments and further research into causality, mechanisms, prevention, and intervention.
前瞻性评估婴儿的心理社会环境是否早在青春期就与心血管代谢风险相关。
参与者在智利圣地亚哥招募，并从婴儿期开始随访。纳入标准包括出生体重≥3kg 且有稳定照顾者的健康婴儿。母亲在婴儿 6-12 个月时报告心理社会环境，包括抑郁症状、生活压力事件、对儿童发展支持不足、父亲缺失和社会经济地位。5 岁和 10 岁时评估体重指数（BMI）z 评分。青少年时检测 BMI z 评分、腰臀比、收缩压和舒张压、脂肪量和体脂百分比、空腹血糖、总胆固醇和高密度脂蛋白胆固醇以及胰岛素稳态模型评估。
青少年年龄在 16-18 岁之间（n=588；48.1%为女性）。婴儿期较差的心理社会环境与 10 岁时的 BMI z 评分（β=0.10，95%置信区间 0.00-0.19）和青春期（β=0.15，95%置信区间 0.06-0.24）相关，但与 5 岁时无关。婴儿期较差的心理社会环境与较高的血压（β=0.15，95%置信区间 0.05-0.24）、更大的人体测量风险（β=0.13，95%置信区间 0.03-0.22）、更大的生物标志物（甘油三酯、胰岛素稳态模型评估、总胆固醇）风险（β=0.12，95%置信区间 0.02-0.22）和青春期代谢综合征的更高可能性相关（优势比 aOR=1.50；95%置信区间 1.06-2.12）。
这些发现表明，较差的婴儿心理社会环境与更大的青少年心血管代谢风险相关。结果支持对婴儿心理社会环境进行筛查，并进一步研究因果关系、机制、预防和干预。
