婴儿期母乳喂养与中老年心血管疾病：英国生物库 36 万参与者的前瞻性研究。

Breastfeeding in infancy and cardiovascular disease in middle-aged and older adulthood: a prospective study of 0.36 million UK Biobank participants.

机构信息

Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

出版信息

J Nutr Health Aging. 2024 Oct;28(10):100347. doi: 10.1016/j.jnha.2024.100347. Epub 2024 Aug 30.

DOI:10.1016/j.jnha.2024.100347

PMID:39216149

Abstract

BACKGROUND

Cardiovascular disease originates in early life. We aimed to investigate the association between breastfeeding in infancy and cardiovascular disease in adult life.

METHODS

We followed 364,240 participants from UK Biobank aged 40-73 years from 2006 - 2010 to 2021. Information on breastfeeding in infancy was self-reported by questionnaire. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the association between breastfeeding and cardiovascular disease in middle-aged and older adulthood. The multivariable Cox models were used by adjusting for the age (used as the time scale), sex, ethnicity, assessment centre, birth weight, multiple birth status, maternal smoking during pregnancy, Townsend deprivation index, smoking status, alcohol drinker status, physical activity, and menopausal status for women. Binary and multinomial multivariable logistic regression models were used to explore the associations of breastfeeding in infancy with cardiovascular disease risk factors including obesity, body composition, metabolic and inflammatory disorders.

RESULTS

During a median of 12.6 years of follow-up, we documented 29,796 new cases of cardiovascular disease, including 24,797 coronary heart disease and 6229 stroke. The multivariable adjusted HRs for breastfed versus non-breastfed were 0.94 (95% CI: 0.91, 0.96) for cardiovascular disease, 0.94 (95% CI: 0.91, 0.96) for coronary heart disease, and 0.95 (95% CI: 0.89, 1.01) for stroke. Furthermore, the strength of observed association between breastfeeding and cardiovascular disease seems to decrease with age (P for interaction <0.001), and increase with polygenic risk for cardiovascular disease (P for interaction <0.001). Consistently, breastfeeding in infancy was associated with cardiovascular disease risk factors including lower body mass index 0.92 (95% CI: 0.89, 0.95), body fat percentage 0.85 (95% CI: 0.83, 0.87), android to gynoid fat ratio 0.89 (95% CI: 0.83, 0.96), visceral adipose tissue 0.92 (95% CI: 0.84, 1.01), as well as lower C-reactive protein level 0.95 (95% CI: 0.94, 0.97) and a lower risk of metabolic syndrome 0.89 (95% CI: 0.85, 0.92).

CONCLUSIONS

Breastfeeding in infancy was associated with a lower risk of cardiovascular disease in middle-aged and older adulthood. Promoting breastfeeding is vital not only for promoting child health, but also for halting the increasing trend of cardiovascular disease in adults.

摘要

背景

心血管疾病起源于生命早期。我们旨在研究婴儿期母乳喂养与成年期心血管疾病之间的关系。

方法

我们随访了来自英国生物银行的 364240 名年龄在 40-73 岁的参与者，随访时间从 2006 年至 2010 年至 2021 年。婴儿期母乳喂养情况通过问卷调查自行报告。使用 Cox 比例风险回归模型估计母乳喂养与中年和老年人群中心血管疾病之间的关联的风险比（HR）和 95%置信区间（CI）。多变量 Cox 模型通过调整年龄（用作时间尺度）、性别、种族、评估中心、出生体重、多胎生育状况、母亲怀孕期间吸烟状况、汤森剥夺指数、吸烟状况、饮酒状况、身体活动状况和女性的绝经状态来调整。使用二项和多项多变量逻辑回归模型来探讨婴儿期母乳喂养与心血管疾病风险因素（包括肥胖、身体成分、代谢和炎症紊乱）的关联。

结果

在中位 12.6 年的随访期间，我们记录了 29796 例新的心血管疾病病例，包括 24797 例冠心病和 6229 例中风。多变量调整后的母乳喂养与非母乳喂养的 HR 分别为心血管疾病 0.94（95%CI：0.91，0.96）、冠心病 0.94（95%CI：0.91，0.96）和中风 0.95（95%CI：0.89，1.01）。此外，观察到的母乳喂养与心血管疾病之间的关联强度似乎随着年龄的增长而减弱（P<0.001），并且随着心血管疾病的多基因风险的增加而增强（P<0.001）。同样，婴儿期母乳喂养与心血管疾病风险因素有关，包括较低的体重指数 0.92（95%CI：0.89，0.95）、体脂肪百分比 0.85（95%CI：0.83，0.87）、安卓到女性脂肪比 0.89（95%CI：0.83，0.96）、内脏脂肪组织 0.92（95%CI：0.84，1.01）以及较低的 C 反应蛋白水平 0.95（95%CI：0.94，0.97）和代谢综合征风险较低 0.89（95%CI：0.85，0.92）。