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幼儿期之前生长发育不良:成年后健康状况下降,寿命缩短。

Poor growth prior to early childhood: decreased health and life-span in the adult.

作者信息

Clark G A, Hall N R, Armelagos G J, Borkan G A, Panjabi M M, Wetzel F T

出版信息

Am J Phys Anthropol. 1986 Jun;70(2):145-60. doi: 10.1002/ajpa.1330700202.

Abstract

Previous studies in animal populations have shown that stunted neural and thymolymphatic growth early in development may result in permanently impaired neural and immune function, decreased body growth, vertebral wedging, and decreased life-span. In the human adult, small vertebral neural canal (VNC) diameters may reflect early stunted neural and immune development and impaired function that leads to decreased health (inferred by greater vertebral wedging) and life-span in the adult. VNC, which complete their growth by early childhood (age 4), are markers of early development in adults. On the other hand, features following general body growth, such as height, weight (represented here by vertebral body height) continues to grow until young adulthood. They are less reliable, because they readily experience catch-up growth (even in chronically stressed populations) and, unlike VNC, may mask poor early growth. To test associations between early growth and adult health and life-span in humans, we measured 2,060 VNC, vertebral heights, vertebral wedging, nerve-root tunnel lengths, severity of vertebral osteophytosis, and ages at death in 90 adult (aged 15-55 years) prehistoric skeletons (950-1300 A.D.). Tibial lengths were also measured in a subsample (n = 30). Multivariate, bivariate, and nonparametric analyses showed that small VNC are significantly associated with greater vertebral wedging and decreased life-span (P less than 0.05-0.00001). VNC are independent of vertebral body heights and tibial lengths (general body growth). VNC, but not statural components, are useful in predicting adult health, presumably because they reflect neural and immune development and do not readily experience catch-up growth. Thus, longitudinal retrospective measures of early growth and adult health were systematically linked within individuals regardless of confounding factors operating over the 350-year time period. Since this research was completed, this model has repeatedly been independently confirmed in four living urban industrial populations. Longitudinal retrospective analysis was employed together with direct measures of VNC, neural and immune function. Together these results suggested that it may be essential to improve growth prior to early childhood in order to maximize adult health and life-span.

摘要

以往对动物种群的研究表明,发育早期神经和胸腺淋巴系统发育迟缓可能导致神经和免疫功能永久性受损、身体生长减缓、椎体楔形变以及寿命缩短。在成年人类中,较小的椎管直径可能反映出早期神经和免疫发育迟缓以及功能受损,进而导致成年后健康状况下降(可通过椎体楔形变加剧推断)和寿命缩短。椎管在儿童早期(4岁)就完成生长,是成年人早期发育的标志。另一方面,一般身体生长后的特征,如身高、体重(此处以椎体高度表示)会持续增长至青年期。它们不太可靠,因为它们很容易经历追赶生长(即使在长期压力较大的人群中也是如此),而且与椎管不同,可能会掩盖早期生长不良的情况。为了测试人类早期生长与成年健康及寿命之间的关联,我们测量了90具成年(年龄在15至55岁之间)史前骨骼(公元950 - 1300年)的2060个椎管、椎体高度、椎体楔形变、神经根通道长度、椎体骨质增生严重程度以及死亡年龄。还对一个子样本(n = 30)测量了胫骨长度。多变量、双变量和非参数分析表明,较小的椎管与更大的椎体楔形变和寿命缩短显著相关(P小于0.05 - 0.00001)。椎管与椎体高度和胫骨长度(一般身体生长指标)无关。椎管,而非身体 stature 指标,有助于预测成年健康状况,大概是因为它们反映了神经和免疫发育,且不容易经历追赶生长。因此,无论在这350年期间存在何种混杂因素,个体内部早期生长和成年健康的纵向回顾性测量都系统地联系在一起。自这项研究完成以来,该模型已在四个现代城市工业人群中多次得到独立验证。采用纵向回顾性分析以及椎管、神经和免疫功能的直接测量方法。这些结果共同表明,为了使成年后的健康和寿命最大化,在儿童早期之前改善生长状况可能至关重要。

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