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从儿童期到成年期,较高的身体质量指数对成年人心血管代谢生物标志物的长期负担:一项 30 年队列研究。

Long-term burden of higher body mass index from childhood on adult cardiometabolic biomarkers: A 30-year cohort study.

机构信息

Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China.

Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China.

出版信息

Nutr Metab Cardiovasc Dis. 2021 Feb 8;31(2):439-447. doi: 10.1016/j.numecd.2020.09.009. Epub 2020 Sep 16.

Abstract

BACKGROUND AND AIMS

Data are limited regarding the association between long-term burden of higher body mass index (BMI) from childhood and cardiometabolic biomarkers.

METHODS AND RESULTS

A total of 1553 individuals aged 6-15 years, who were examined 4 or more times for BMI since childhood and followed for 30 years were included in our analysis. Total area under the curve (AUCt) and incremental AUC (AUCi) were calculated as the long-term burden and trends of BMI. Cardiometabolic biomarkers including serum uric acid (SUA), fasting blood-glucose (FBG), and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) were obtained from venous blood samples. The results showed a positive association of BMI AUCt and AUCi with cardiometabolic biomarkers. After adjusting for demographic variables, the AUCt and AUCi of BMI were significantly associated with a higher level of SUA (β = 3.71; 2.87), FBG (β = 0.09; 0.09), and TG/HDL-C (β = 0.14; 0.11). We performed further studies after dividing subjects into four groups according to AUCt and AUCi of BMI by quartiles. Compared with the lowest quartile group, the highest quartile group had significantly increased risk ratios of hyperuricemia (RR = 2.01; 1.74), type 2 diabetes mellitus (RR = 8.18; 3.96), and high-risk TG/HDL-C (RR = 4.05; 3.26).

CONCLUSION

Our study identifies all subjects' BMI growth curve from childhood and indicates that the long-term burden of higher BMI significantly increases the cardiometabolic risk, and the impact of excessive body weight on cardiometabolic health originates in early life. We emphasize the importance of weight control from childhood for cardiometabolic health.

摘要

背景与目的

关于儿童期较高体重指数(BMI)长期负担与心脏代谢生物标志物之间的关联,相关数据有限。

方法和结果

本研究共纳入了 1553 名年龄在 6-15 岁之间的个体,他们在儿童时期接受了 4 次或更多次 BMI 检查,并随访了 30 年。总曲线下面积(AUCt)和增量 AUC(AUCi)被计算为 BMI 的长期负担和趋势。心脏代谢生物标志物包括血清尿酸(SUA)、空腹血糖(FBG)和甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C),从静脉血样中获得。结果显示,BMI AUCt 和 AUCi 与心脏代谢生物标志物呈正相关。在校正了人口统计学变量后,BMI 的 AUCt 和 AUCi 与 SUA(β=3.71;2.87)、FBG(β=0.09;0.09)和 TG/HDL-C(β=0.14;0.11)水平升高显著相关。我们根据 BMI 的 AUCt 和 AUCi 将研究对象分为四组后进行了进一步研究。与最低四分位组相比,最高四分位组发生高尿酸血症(RR=2.01;1.74)、2 型糖尿病(RR=8.18;3.96)和高危 TG/HDL-C(RR=4.05;3.26)的风险比显著增加。

结论

本研究确定了所有研究对象的 BMI 生长曲线,表明较高 BMI 的长期负担显著增加了心脏代谢风险,超重对心脏代谢健康的影响起源于生命早期。我们强调了从儿童时期开始控制体重对心脏代谢健康的重要性。

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