Zhang Yue, Zhou Yaguan, Cheng Yangyang, Carrillo-Larco Rodrigo M, Fawad Muhammad, Chen Shu, Xu Xiaolin
School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China.
Commun Med (Lond). 2023 Jul 31;3(1):105. doi: 10.1038/s43856-023-00335-4.
Little is known about the relationship between early life body size and occurrence of life-course multiple chronic diseases (multimorbidity). We aim to evaluate associations of birth weight, childhood body size, and their changes with the risks of chronic diseases and multimorbidity.
This prospective cohort study included 246,495 UK Biobank participants (aged 40-69 years) who reported birth weight and childhood body size at 10 years old. Birth weight was categorized into low, normal, and high; childhood body size was reported as being thinner, average, or plumper. Multimorbidity was defined as having two or more of 38 chronic conditions retrieved from inpatient hospital data until 31 December, 2020. The Cox regression and quasi-Poisson mixed effects models were used to estimate the associations.
We show that 57,071 (23.2%) participants develop multimorbidity. Low birth weight (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.26-1.33), high birth weight (HR 1.02, 95% CI > 1.00-1.05), thinner (HR 1.21, 95% CI 1.18-1.23) and plumper body size (HR 1.06, 95% CI 1.04-1.09) are associated with higher risks of multimorbidity. A U-shaped relationship between birth weight and multimorbidity is observed. Changing to be thinner or plumper is associated with multimorbidity and many conditions, compared to changing to be average.
Low birth weight, being thinner and changing to have a thinner body size in childhood are associated with higher risks of developing multimorbidity and many chronic conditions in adulthood. Early monitoring and maintaining a normal body size in childhood could have life-course benefits for preventing multimorbidity above and beyond individual conditions.
关于生命早期的体型与生命历程中多种慢性疾病（多病共存）发生之间的关系，我们所知甚少。我们旨在评估出生体重、儿童期体型及其变化与慢性疾病和多病共存风险之间的关联。
这项前瞻性队列研究纳入了246495名英国生物银行的参与者（年龄在40 - 69岁之间），他们报告了出生体重和10岁时的儿童期体型。出生体重分为低、正常和高；儿童期体型报告为较瘦、平均或较胖。多病共存定义为截至2020年12月31日从住院医院数据中检索到的38种慢性疾病中的两种或更多种。采用Cox回归和准泊松混合效应模型来估计关联。
我们发现57071名（23.2%）参与者发生了多病共存。低出生体重（风险比[HR] 1.29，95%置信区间[CI] 1.26 - 1.33）、高出生体重（HR 1.02，95% CI > 1.00 - 1.05）、较瘦（HR 1.21，95% CI 1.18 - 1.23）和较胖体型（HR 1.06，95% CI 1.04 - 1.09）与更高的多病共存风险相关。观察到出生体重与多病共存之间呈U形关系。与体型变为平均相比，体型变瘦或变胖与多病共存及多种疾病相关。
低出生体重、较瘦以及儿童期体型变瘦与成年期发生多病共存及多种慢性疾病的较高风险相关。儿童期进行早期监测并维持正常体型可能对预防多病共存及个体疾病之外的情况具有生命历程益处。
