Rodríguez-López Mérida, Sepúlveda-Martínez Álvaro, Bernardino Gabriel, Crovetto Francesca, Pajuelo Carolina, Sitges Marta, Bijnens Bart, Gratacós Eduard, Crispi Fàtima
BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Centro de Investigaciones Biomédica en Red - Enfermedades Raras, Universitat de Barcelona, Barcelona, Spain.
Faculty of Health Science, Universidad Icesi, Cali, Colombia.
Front Cardiovasc Med. 2023 Oct 25;10:1223928. doi: 10.3389/fcvm.2023.1223928. eCollection 2023.
This study aimed to assess the cardiometabolic sex similarities and differences in adults born small for gestational age.
This study was an ambispective cohort study from a birth registry in Barcelona, Spain, including 523 adult participants (20-40 years-old) subdivided as born small for gestational age (SGA, if birth weight <10th centile) or adequate fetal growth for gestational age (AGA). Cardiometabolic health was assessed by echocardiography, electrocardiogram, blood pressure measurement, vascular ultrasound, anthropometric measurements, and serum glycemia and lipid profile. Stratified analyses by sex were performed by estimation of adjusted absolute difference (AAD) using inverse probability weighting.
Compared with AGA, the stratified analyses by sex showed a more pronounced reduction in ejection fraction [AAD: female -1.73 (95% CI -3.2 to -0.28) vs. male -1.33 (-3.19 to 0.52)] and increment in heart rate [female 3.04 (0.29-5.8) vs. male 2.25 (-0.82 to 5.31)] in SGA females compared with SGA males. In contrast, a more pronounced reduction in PR interval [female -1.36 (-6.15 to 3.42) vs. male -6.61 (-11.67 to -1.54)] and an increase in systolic blood pressure [female 0.06 (-2.7 to 2.81) vs. male 2.71 (-0.48 to 5.9)] and central-to-peripheral fat ratio [female 0.05 (-0.03 to 0.12) vs. male 0.40 (0.17-0.62)] were mainly observed in SGA male compared with SGA female.
Sex differences were observed in the effect of SGA on cardiometabolic endpoints with female being more prone to cardiac dysfunction and male to electrocardiographic, vascular, and metabolic changes. Future research including sex-stratification data is warranted.
本研究旨在评估小于胎龄出生的成年人心脏代谢方面的性别异同。
本研究是一项来自西班牙巴塞罗那出生登记处的双向队列研究,纳入了523名成年参与者(20至40岁),分为小于胎龄出生(SGA,若出生体重低于第10百分位数)或适于胎龄生长(AGA)。通过超声心动图、心电图、血压测量、血管超声、人体测量以及血清血糖和血脂谱评估心脏代谢健康状况。采用逆概率加权法估计调整后的绝对差异(AAD),按性别进行分层分析。
与AGA相比,按性别分层分析显示,SGA女性与SGA男性相比,射血分数下降更为明显[AAD:女性为-1.73(95%CI -3.2至-0.28),男性为-1.33(-3.19至0.52)],心率增加更为明显[女性为3.04(0.29至5.8),男性为2.25(-0.82至5.31)]。相反,与SGA女性相比,SGA男性主要观察到PR间期下降更为明显[女性为-1.36(-6.15至3.42),男性为-6.61(-11.67至-1.54)],收缩压升高[女性为0.06(-2.7至2.81),男性为2.71(-0.48至5.9)]以及中心与外周脂肪比率增加[女性为0.05(-0.03至0.12),男性为0.40(0.17至0.62)]。
观察到SGA对心脏代谢终点的影响存在性别差异,女性更易出现心脏功能障碍,而男性更易出现心电图、血管和代谢方面的变化。有必要开展纳入性别分层数据的未来研究。