Institute of Cardiovascular Diseases and Department of Cardiology, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu China.
J Am Heart Assoc. 2024 Aug 6;13(15):e035365. doi: 10.1161/JAHA.124.035365. Epub 2024 Jul 31.
The causal relationship between childhood adiposity and adult risk of heart diseases has not been clearly demonstrated. This study aims to ascertain whether genetically predicted childhood body mass index (BMI) and childhood obesity are causally associated with adult coronary heart disease, myocardial infarction, heart failure, atrial fibrillation, hypertrophic cardiomyopathy, and pulmonary heart disease.
To investigate the causative relationships and underlying mechanisms between childhood adiposity and adult heart diseases, 3 main methods of Mendelian randomization were used: 2-sample Mendelian randomization, multivariable Mendelian randomization with controlling for several cardiometabolic risk variables, and mediation analysis. Every 1-SD rise in genetically predicted childhood body mass index was associated with 24% (odds ratio [OR], 1.24 [95% CI, 1.12-1.37]), 28% (OR, 1.28 [95% CI, 1.14-1.42]), 28% (OR, 1.28 [95% CI, 1.14-1.42]), and 27% (OR, 1.27 [95% CI, 1.04-1.49]) higher risk of coronary heart disease, myocardial infarction, heart failure, and atrial fibrillation, respectively. Every 1-unit increase in log-odds in childhood obesity was associated with 11% (OR, 1.11 [95% CI, 1.06-1.16]), 14% (OR, 1.14 [95% CI, 1.04-1.23]), 10% (OR, 1.10 [95% CI, 1.03-1.18]), and 20% (OR, 1.20 [95% CI, 1.08-1.32]) higher risk of coronary heart disease, myocardial infarction, heart failure, and atrial fibrillation, respectively. The link between childhood adiposity and adult heart diseases was found to be mediated by high-density lipoprotein cholesterol, triglyceride, hypertension, and type 2 diabetes.
Our findings support the causal relationships between childhood adiposity and risk of adult coronary heart disease, myocardial infarction, heart failure, and atrial fibrillation. Blood lipids, hypertension, and type 2 diabetes are factors that mediate the aforementioned associations.
儿童肥胖与成人患心脏病风险之间的因果关系尚未得到明确证实。本研究旨在确定遗传预测的儿童体重指数（BMI）和儿童肥胖是否与成人冠心病、心肌梗死、心力衰竭、心房颤动、肥厚型心肌病和肺心病有因果关系。
为了研究儿童期肥胖与成人心脏病之间的因果关系和潜在机制，本研究采用了孟德尔随机化的 3 种主要方法：两样本孟德尔随机化、多变量孟德尔随机化（控制多种心血管代谢风险变量）和中介分析。每增加一个标准差的遗传预测儿童 BMI，与冠心病、心肌梗死、心力衰竭和心房颤动的风险分别增加 24%（比值比[OR]，1.24[95%置信区间，1.12-1.37]）、28%（OR，1.28[95%置信区间，1.14-1.42]）、28%（OR，1.28[95%置信区间，1.14-1.42]）和 27%（OR，1.27[95%置信区间，1.04-1.49]）相关。每增加一个对数单位的儿童肥胖，与冠心病、心肌梗死、心力衰竭和心房颤动的风险分别增加 11%（OR，1.11[95%置信区间，1.06-1.16]）、14%（OR，1.14[95%置信区间，1.04-1.23]）、10%（OR，1.10[95%置信区间，1.03-1.18]）和 20%（OR，1.20[95%置信区间，1.08-1.32]）相关。儿童肥胖与成人心脏病之间的联系被发现是通过高密度脂蛋白胆固醇、甘油三酯、高血压和 2 型糖尿病介导的。
我们的研究结果支持儿童肥胖与成人冠心病、心肌梗死、心力衰竭和心房颤动风险之间的因果关系。血脂、高血压和 2 型糖尿病是介导上述关联的因素。
