State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China.
Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China.
Nutr Metab Cardiovasc Dis. 2021 Aug 26;31(9):2637-2643. doi: 10.1016/j.numecd.2021.05.017. Epub 2021 May 25.
Birth weight has been linked to cardiovascular disease (CVD) risk in adulthood, but no consensus has emerged on the threshold of birth weight for the lowest CVD risk and few studies have examined potential interaction between birth weight and adult adiposity.
A total of 256,787 participants, who had birth weight data and were free of CVD at baseline, were included from UK Biobank. Multivariate restricted cubic splines and Cox regression models were used to assess the association between birth weight and CVD. We observed nonlinear inverse associations of birth weight with the risk of coronary heart disease (CHD), stroke, and heart failure. Participants with the first quintile of birth weight (≤2.85 kg) had higher risks for CHD (hazard ratio [HR] = 1.23, 95% confidence interval [CI]: 1.15-1.32), stroke (HR = 1.19, 95% CI: 1.03-1.37), and heart failure (HR = 1.28, 95% CI: 1.11-1.48), as compared to the fourth quintile (3.41-3.79 kg). There was a significant interaction between birth weight and adult body mass index (BMI) on CHD and heart failure (both P for interaction <0.001), showing the highest risk for those who had birth weight ≤2.85 kg and BMI ≥30 kg/m (HR = 1.96, 95% CI: 1.70-2.25 and HR = 2.39, 95% CI: 1.77-3.22, respectively).
Our findings indicate nonlinear inverse associations between birth weight and CVD risk, with a threshold of 3.41-3.79 kg for the lowest risk. Moreover, low birth weight may interact with adult obesity to increase the risk of CHD and heart failure.
出生体重与成年人的心血管疾病（CVD）风险相关，但对于出生体重的最低 CVD 风险阈值尚未达成共识，且很少有研究探讨出生体重与成年肥胖之间的潜在相互作用。
本研究共纳入了 256787 名参与者，他们在基线时均有出生体重数据且无 CVD。使用多元受限立方样条和 Cox 回归模型评估了出生体重与 CVD 之间的关系。我们发现出生体重与冠心病（CHD）、中风和心力衰竭风险之间存在非线性反比关系。出生体重处于第一五分位数（≤2.85kg）的参与者发生 CHD（危险比[HR] = 1.23，95%置信区间[CI]：1.15-1.32）、中风（HR = 1.19，95% CI：1.03-1.37）和心力衰竭（HR = 1.28，95% CI：1.11-1.48）的风险更高，与第四五分位数（3.41-3.79kg）相比。出生体重与成人 BMI（体重指数）之间存在 CHD 和心力衰竭的显著交互作用（两者 P 交互均<0.001），表明出生体重≤2.85kg 且 BMI≥30kg/m2 的个体风险最高（HR = 1.96，95% CI：1.70-2.25 和 HR = 2.39，95% CI：1.77-3.22）。
本研究结果表明出生体重与 CVD 风险之间存在非线性反比关系，最低风险的阈值为 3.41-3.79kg。此外，低出生体重可能与成年肥胖相互作用，增加 CHD 和心力衰竭的风险。
