Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland; Unit of Primary Health Care, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
J Pediatr. 2020 Jun;221:151-158.e1. doi: 10.1016/j.jpeds.2020.03.007.
To evaluate the influence of early growth patterns that have previously been associated with later cardiometabolic risk on cardiac left ventricular (LV) structure and function in midlife.
A subpopulation of the Northern Finland Birth Cohort 1966 took part in follow-up, including echocardiography (n = 1155) at the age of 46 years. Body mass index (BMI) growth curves were modeled based on frequent anthropometric measurements in childhood. Age and BMI at adiposity peak (n = 482, mean age 9.0 months) and at adiposity rebound (n = 586, mean age 5.8 years) were determined. Results are reported as unstandardized beta (β) or OR with 95% CIs for 1 SD increase in early growth variable.
Earlier adiposity rebound was associated with increased LV mass index (β = -4.10 g/m (-6.9, -1.3); P = .004) and LV end-diastolic volume index (β = -2.36 mL/m (-3.9, -0.84); P = .002) as well as with eccentric LV hypertrophy (OR 0.54 [0.38, 0.77]; P = .001) in adulthood in males. BMI at adiposity rebound was directly associated with LV mass index (β = 2.33 g/m [0.80, 3.9]; P = .003). Higher BMI at both adiposity peak and at adiposity rebound were associated with greater LV end-diastolic volume index (β = 1.47 mL/m; [0.51, 2.4], β = 1.28 mL/m [0.41, 2.2], respectively) and also with eccentric LV hypertrophy (OR 1.41 [1.10, 1.82], OR 1.53 [1.23, 1.91], respectively) and LV concentric remodeling (OR 1.38 [1.02, 1.87], OR 1.40 [1.06, 1.83], respectively) in adulthood (P < .05 for all). These relationships were only partly mediated by adult BMI.
Early growth patterns in infancy and childhood contribute to cardiac structure at midlife.
评估先前与后期心血管代谢风险相关的早期生长模式对中年人左心室（LV）结构和功能的影响。
芬兰北部出生队列 1966 年的一个亚群参加了随访，包括在 46 岁时进行超声心动图（n=1155）。根据儿童时期频繁的人体测量数据来建立体重指数（BMI）生长曲线。确定肥胖高峰期（n=482，平均年龄 9.0 个月）和肥胖反弹期（n=586，平均年龄 5.8 岁）的 BMI 和年龄。结果以早期生长变量每增加 1 个标准差的未标准化β（β）或比值比（OR）报告，并给出 95%置信区间（CI）。
较早的肥胖反弹与 LV 质量指数（β=-4.10 g/m（-6.9，-1.3）；P=0.004）和 LV 舒张末期容积指数（β=-2.36 mL/m（-3.9，-0.84）；P=0.002）增加以及男性成年人心室向心性重构（OR 0.54[0.38，0.77]；P=0.001）有关。肥胖反弹时的 BMI 与 LV 质量指数直接相关（β=2.33 g/m[0.80，3.9]；P=0.003）。肥胖高峰期和肥胖反弹期的 BMI 较高均与更大的 LV 舒张末期容积指数（β=1.47 mL/m[0.51，2.4]，β=1.28 mL/m[0.41，2.2]）以及向心性重构（OR 1.41[1.10，1.82]，OR 1.53[1.23，1.91]）有关，在成年期（P<0.05）。这些关系部分通过成年 BMI 介导。
婴儿期和儿童期的早期生长模式会导致中年人心脏结构发生变化。
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