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出生条件和儿童期营养状况与 30 岁时心血管代谢危险因素的关系:一项队列研究。

Birth conditions nutritional status in childhood associated with cardiometabolic risk factors at 30 years of age: a cohort study.

机构信息

Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil.

Universidade Federal do Rio Grande, Rio Grande, Brasil.

出版信息

Cad Saude Publica. 2023 Jun 26;39(6):e00215522. doi: 10.1590/0102-311XEN215522. eCollection 2023.

Abstract

This study aimed to assess the association of birth conditions, nutritional status, and childhood growth with cardiometabolic risk factors at 30 years of age. We also evaluated whether body mass index (BMI) at 30 years mediated the association of weight gain in childhood with cardiometabolic risk factors. This is a prospective cohort study that included all live births in 1982 in hospitals in the city of Pelotas, Rio Grande do Sul State, Brazil, whose families lived in the urban area. Mothers were interviewed at birth, and participants were followed at different ages. For our analyses, we used data on weight and height collected at birth, 2 and 4 years and cardiovascular risk factors at 30 years. Multiple linear regressions were performed to obtain adjusted coefficients and G-formula for mediation analysis. Relative weight gain in childhood, despite the age, was positively related to mean arterial pressure, whereas relative weight gain in late childhood was positively associated with carotid intima-media thickness, pulse wave velocity, triglycerides, non-HDL cholesterol, plasma glucose, and C-reactive protein. BMI in adulthood captured the total effect of relative weight gain in the period between 2 and 4 years on carotid intima-media thickness, triglycerides, non-HDL cholesterol, and C-reactive protein. Our findings reinforce the evidence that rapid relative weight gain after 2 years of age may have long-term consequences on the risk of metabolic and cardiovascular disorders.

摘要

本研究旨在评估出生状况、营养状况和儿童期生长与 30 岁时心血管代谢危险因素的关系。我们还评估了 30 岁时的体重指数(BMI)是否介导了儿童期体重增加与心血管代谢危险因素的关系。这是一项前瞻性队列研究,纳入了巴西南里奥格兰德州佩洛塔斯市所有 1982 年出生于医院的活产儿,其家庭居住在城市地区。母亲在分娩时接受了访谈,参与者在不同年龄阶段接受了随访。在我们的分析中,我们使用了出生时、2 岁和 4 岁时收集的体重和身高数据,以及 30 岁时的心血管危险因素数据。我们进行了多元线性回归分析,以获得调整后的系数和 G 公式进行中介分析。尽管年龄不同,但儿童期的相对体重增加与平均动脉压呈正相关,而儿童后期的相对体重增加与颈动脉内膜-中层厚度、脉搏波速度、甘油三酯、非高密度脂蛋白胆固醇、血浆葡萄糖和 C 反应蛋白呈正相关。成年时的 BMI 捕获了 2 至 4 岁期间相对体重增加对颈动脉内膜-中层厚度、甘油三酯、非高密度脂蛋白胆固醇和 C 反应蛋白的总效应。我们的研究结果强化了这样一种证据,即 2 岁后相对体重快速增加可能对代谢和心血管疾病风险产生长期影响。

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