Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium.
Research Unit Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
JAMA Netw Open. 2022 Aug 1;5(8):e2225521. doi: 10.1001/jamanetworkopen.2022.25521.
Adult telomere length (TL) is a biological marker of aging associated with vascular health. TL at birth is associated with later life TL and may contain early biological information of later life cardiovascular health and disease.
To evaluate whether newborn TL is associated with early life blood pressure differences in childhood.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study was part of the ENVIRONAGE (Environmental Influence on Aging in Early Life) study, a birth cohort of Belgian mother-child pairs with recruitment at birth and a median follow-up of 4.5 years conducted between October 2014 and July 2021. Participants included for analysis provided full data for evaluation at follow-up visit. Data analysis was conducted between August and September 2021.
Cord blood and placental average relative TL were measured at birth using quantitative polymerase chain reaction (qPCR). Systolic, diastolic, and mean arterial pressure (MAP) were evaluated at follow-up. High childhood blood pressure (standardized for child age, sex, and height) was defined following the 2017 American Academy of Pediatrics guidelines. Multivariable adjusted linear and logistic regression models were used to associate newborn TL and blood pressure indicators in childhood.
This study included 485 newborn children (52.8% girls) with a mean (SD) age of 4.6 (0.4) years at the follow-up visit. Newborn TL was associated with lower blood pressure in childhood. A 1-IQR increase in cord blood TL was associated with a -1.54 mm Hg (95% CI, -2.36 to -0.72 mm Hg) lower diastolic blood pressure and -1.18 mm Hg (95% CI, -1.89 to -0.46 mm Hg) lower MAP. No association was observed with systolic blood pressure. Furthermore, a 1-IQR increase in cord blood TL was associated with lower odds of having high blood pressure at the age of 4 to 6 years (adjusted OR, 0.72; 95% CI, 0.53 to 0.98). In placenta, a 1-IQR increase in TL was associated with a -0.96 mm Hg (95% CI, -1.72 to -0.21 mm Hg) lower diastolic, -0.88 mm Hg (95% CI, -1.54 to -0.22 mm Hg) lower MAP, and a lower adjusted OR of 0.69 (95% CI, 0.52 to 0.92) for having a high blood pressure in childhood.
In this prospective birth cohort study, variation in early life blood pressure at school-age was associated with TL at birth. Cardiovascular health may to some extent be programmed at birth, and these results suggest that TL entails a biological mechanism in this programming.
成人端粒长度（TL）是与血管健康相关的衰老的生物标志物。出生时的 TL 与以后的生活 TL 有关，并且可能包含以后的生活心血管健康和疾病的早期生物学信息。
评估新生儿 TL 是否与儿童期早期的血压差异有关。
设计、地点和参与者：这项队列研究是 ENVIRONAGE（早期生活中的环境对衰老的影响）研究的一部分，这是一项比利时母婴对子的出生队列研究，于 2014 年 10 月至 2021 年 7 月期间进行招募，随访时间中位数为 4.5 年。分析中包括在随访时提供完整数据进行评估的参与者。数据分析于 2021 年 8 月至 9 月进行。
使用定量聚合酶链反应（qPCR）在出生时测量脐带血和胎盘的平均相对 TL。在随访时评估收缩压、舒张压和平均动脉压（MAP）。根据 2017 年美国儿科学会指南，将儿童期的高血压（按儿童年龄、性别和身高标准化）定义为。使用多变量调整的线性和逻辑回归模型来关联新生儿 TL 和儿童期的血压指标。
这项研究包括 485 名新生儿（52.8%为女孩），在随访时的平均（SD）年龄为 4.6（0.4）岁。新生儿 TL 与儿童期较低的血压有关。脐带血 TL 增加 1-四分位距与舒张压降低 1.54 毫米汞柱（95%CI，-2.36 至-0.72 毫米汞柱）和 MAP 降低 1.18 毫米汞柱（95%CI，-1.89 至-0.46 毫米汞柱）有关。与收缩压无关。此外，脐带血 TL 增加 1-四分位距与 4 至 6 岁时高血压的几率降低有关（调整后的 OR，0.72；95%CI，0.53 至 0.98）。在胎盘组织中，TL 增加 1-四分位距与舒张压降低 0.96 毫米汞柱（95%CI，-1.72 至-0.21 毫米汞柱）、MAP 降低 0.88 毫米汞柱（95%CI，-1.54 至-0.22 毫米汞柱）以及儿童期高血压的调整后 OR 降低 0.69（95%CI，0.52 至 0.92）有关。
在这项前瞻性出生队列研究中，学龄期早期的血压变化与出生时的 TL 有关。心血管健康在某种程度上可能在出生时就已编程，这些结果表明 TL 在这种编程中存在生物学机制。
