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从出生到幼儿期的维生素D轨迹与儿童及青少年期收缩压升高

Vitamin D Trajectories From Birth to Early Childhood and Elevated Systolic Blood Pressure During Childhood and Adolescence.

作者信息

Wang Guoying, Liu Xin, Bartell Tami R, Pearson Colleen, Cheng Tina L, Wang Xiaobin

机构信息

From the Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (G.W., X.W.).

CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, University of Chinese Academy of Sciences, China (X.L.).

出版信息

Hypertension. 2019 Aug;74(2):421-430. doi: 10.1161/HYPERTENSIONAHA.119.13120. Epub 2019 Jul 1.

Abstract

Vitamin D deficiency is associated with hypertension in adults. It is unknown to what degree vitamin D status in early life can affect blood pressure (BP) a decade later. This study investigated the effect of vitamin D trajectory through early life on systolic BP (SBP) in childhood. This is a prospective birth cohort study of 775 children enrolled from 2005 to 2012 and followed prospectively up to age 18 years at the Boston Medical Center, Boston, MA. Persistent low vitamin D status is defined as plasma 25(OH)D <11 ng/mL at birth and <25 ng/mL in early childhood. Elevated SBP is defined as SBP ≥75th percentile. Low vitamin D status at birth was associated with higher risk of elevated SBP at ages 3 to 18 years: odds ratio, 1.38; (95% CI, 1.01-1.87) compared to those with sufficient vitamin D. Low vitamin D status in early childhood was associated with a 1.59-fold (95% CI, 1.02-2.46) higher risk of elevated SBP at age 6 to 18 years. Persistent low vitamin D status from birth to early childhood was associated with higher risk of elevated SBP (odds ratio, 2.04; [95% CI, 1.13-3.67]) at ages 3 to 18 years. These results suggest that low vitamin D status and trajectory in early life were associated with increased risk of elevated SBP during childhood and adolescence. Our findings will help inform future clinical and public health strategies for vitamin D screening and supplementation in pregnancy and childhood to prevent or reduce risk of elevated BP across the lifespan and generations.

摘要

维生素D缺乏与成年人高血压相关。尚不清楚生命早期的维生素D状态在多大程度上会影响十年后的血压(BP)。本研究调查了生命早期维生素D轨迹对儿童收缩压(SBP)的影响。这是一项前瞻性出生队列研究,纳入了2005年至2012年招募的775名儿童,并在马萨诸塞州波士顿的波士顿医学中心对其进行前瞻性随访,直至18岁。持续性低维生素D状态定义为出生时血浆25(OH)D<11 ng/mL,幼儿期<25 ng/mL。SBP升高定义为SBP≥第75百分位数。出生时低维生素D状态与3至18岁时SBP升高风险较高相关:与维生素D充足的儿童相比,比值比为1.38;(95%CI,1.01-1.87)。幼儿期低维生素D状态与6至18岁时SBP升高风险高1.59倍(95%CI,1.02-2.46)相关。从出生到幼儿期持续性低维生素D状态与3至18岁时SBP升高风险较高相关(比值比,2.04;[95%CI,1.13-3.67])。这些结果表明,生命早期低维生素D状态和轨迹与儿童期和青少年期SBP升高风险增加相关。我们的研究结果将有助于为未来关于孕期和儿童期维生素D筛查和补充的临床和公共卫生策略提供信息,以预防或降低一生中及几代人患高血压的风险。

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