Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden.
Clinical Trials Unit, Skåne University Hospital, Lund, Sweden.
PLoS One. 2024 Mar 1;19(3):e0299725. doi: 10.1371/journal.pone.0299725. eCollection 2024.
Early life factors may predict cardiovascular disease (CVD), but the pathways are still unclear. There is emerging evidence of an association of early life factors with apolipoproteins, which are linked to CVD. The study objective was to assess the associations between birth variables and adult apolipoproteins (apoA1 and apoB, and their ratio) in a population-based cohort.
The LifeGene Study is a prospective cohort comprising index participants randomly sampled from the general population. Blood samples were collected between 2009 and 2016. In this sub-study, we used birth variables, obtained from a national registry for all participants born 1973 or later, including birth weight and gestational age, while adult CVD risk factors included age, sex, body mass index (BMI), lipids, and smoking history. We employed univariate and multivariate general linear regression to explore associations between birth variables, lipid levels and other adult CVD risk factors. The outcomes included non-fasting apoA1 and apoB and their ratio, as well as total cholesterol and triglycerides. A total of 10,093 participants with both birth information and lipoprotein levels at screening were included. Of these, nearly 42.5% were men (n = 4292) and 57.5% were women (n = 5801).
The mean (standard deviation) age of men was 30.2 (5.7) years, and for women 28.9 (5.8) years. There was an increase of 0.022 g/L in apoA1 levels per 1 kg increase in birth weight (p = 0.005) after adjusting for age, sex, BMI, gestational age, and smoking history. Similarly, there was a decrease of 0.023 g/L in apoB levels per 1 kg increase in birth weight (p<0.001) after adjusting for the same variables. There were inverse associations of birth weight with the apoB/apoA1 ratio. No independent association was found with total cholesterol, but with triglyceride levels (ẞ-coefficient (95% Confidence Interval); -0.067 (-0.114, -0.021); p-value 0.005).
Lower birth weight was associated with an adverse adult apolipoprotein pattern, i.e., a higher apoB/apoA1 ratio, indicating increased risk of future CVD manifestations. The study highlights the need of preconception care and pregnancy interventions that aim at improving maternal and child outcomes with long-term impacts for prevention of cardiovascular disease by influencing lipid levels.
早期生活因素可能预示着心血管疾病（CVD），但其作用途径尚不清楚。越来越多的证据表明，早期生活因素与载脂蛋白有关，载脂蛋白与 CVD 有关。本研究的目的是评估人群中出生变量与成年载脂蛋白（apoA1 和 apoB 及其比值）之间的关系。
LifeGene 研究是一项基于人群的前瞻性队列研究，其指数参与者是从一般人群中随机抽取的。血液样本采集于 2009 年至 2016 年期间。在这项子研究中，我们使用了出生变量，这些变量来自所有 1973 年或以后出生的参与者的国家登记处，包括出生体重和胎龄，而成年 CVD 危险因素包括年龄、性别、体重指数（BMI）、血脂和吸烟史。我们采用单变量和多变量线性回归来探讨出生变量、血脂水平和其他成年 CVD 危险因素之间的关系。结果包括非禁食 apoA1 和 apoB 及其比值以及总胆固醇和甘油三酯。共有 10093 名参与者在筛查时同时提供了出生信息和脂蛋白水平，其中近 42.5%（n=4292）为男性，57.5%（n=5801）为女性。
男性的平均（标准差）年龄为 30.2（5.7）岁，女性为 28.9（5.8）岁。在校正年龄、性别、BMI、胎龄和吸烟史后，每增加 1 公斤体重，apoA1 水平增加 0.022g/L（p=0.005）。同样，在校正相同变量后，apoB 水平每增加 1 公斤体重，apoB/apoA1 比值降低 0.023g/L（p<0.001）。出生体重与 apoB/apoA1 比值呈负相关。与总胆固醇无独立相关性，但与甘油三酯水平呈负相关（β 系数（95%置信区间）；-0.067（-0.114，-0.021）；p 值 0.005）。
较低的出生体重与不良的成年载脂蛋白模式有关，即 apoB/apoA1 比值升高，表明未来 CVD 表现的风险增加。该研究强调了需要进行孕前保健和妊娠干预，以改善母婴结局，通过影响血脂水平，从而对心血管疾病的预防产生长期影响。
