Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
Ann Med. 2021 Dec;53(1):160-168. doi: 10.1080/07853890.2020.1849785.
Increased left ventricular mass (LVM) predicts cardiovascular events and mortality. The objective of this study was to determine whether early-life exposures to body mass index (BMI) and systolic blood pressure (SPB) affects the left ventricular structure in adulthood.
We used longitudinal data from a 31-year follow-up to examine the associations between early-life (between ages 6-18) BMI and SPB on LVM in an adult population ( = 1864, aged 34-49). The burden of early-life BMI and SBP was defined as area under the curve.
After accounting for contemporary adult determinants of LVM, early-life BMI burden associated significantly with LVM (3.61 g/SD increase in early-life BMI; [1.94 - 5.28], < 0.001). Overweight in early-life (age- and sex-specific BMI values corresponding to adult BMI > 25 kg/m) associated with 4.7% (2.5-6.9%, < 0.0001) higher LVM regardless of BMI status in adulthood. Overweight in early-life combined with obesity in adulthood (BMI > 30kg/m) resulted in a 21% (17.3-32.9%, < 0.0001) increase in LVM. Higher early-life BMI was associated with a risk of developing eccentric hypertrophy. The burden of early-life SPB was not associated with adult LVM or left ventricular remodeling.
High BMI in early-life confers a sustained effect on LVM and the risk for eccentric hypertrophy independently of adulthood risk factors. KEY MESSAGES Excess in BMI in early-life has an independent effect on LVM and the risk of developing eccentric hypertrophy regardless of overweight status in adulthood. Systolic blood pressure levels in early-life did not have an independent effect on LVM or LV remodeling. The clinical implication of this study is that primary prevention of obesity in early-life may prevent the development of high LVM and eccentric hypertrophy.
左心室质量（LVM）增加可预测心血管事件和死亡率。本研究旨在确定生命早期的体重指数（BMI）和收缩压（SPB）暴露是否会影响成年后的左心室结构。
我们使用 31 年随访的纵向数据，在成年人群中（n=1864，年龄 34-49 岁）检查生命早期（6-18 岁）BMI 和 SPB 与 LVM 之间的关系。生命早期 BMI 和 SBP 的负担定义为曲线下面积。
在考虑了当代成人 LVM 的决定因素后，生命早期 BMI 负担与 LVM 显著相关（生命早期 BMI 每增加 1 个标准差，LVM 增加 3.61g[1.94-5.28]， < 0.001）。生命早期超重（根据成人 BMI 值大于 25kg/m2 的相应年龄和性别特异性 BMI 值定义）与 LVM 增加 4.7%（2.5-6.9%， < 0.0001）相关，无论成年时 BMI 状态如何。生命早期超重合并成年肥胖（BMI>30kg/m）导致 LVM 增加 21%（17.3-32.9%， < 0.0001）。生命早期较高的 BMI 与发生离心性肥厚的风险相关。生命早期 SPB 的负担与成人 LVM 或左心室重构无关。
生命早期的高 BMI 对 LVM 有持续影响，并独立于成年期危险因素增加发生离心性肥厚的风险。
生命早期 BMI 过多会对 LVM 产生独立影响，并增加发生离心性肥厚的风险，无论成年期是否超重。生命早期的收缩压水平对 LVM 或 LV 重构没有独立影响。本研究的临床意义在于，生命早期肥胖的一级预防可能预防高 LVM 和离心性肥厚的发生。
