Luo Da, Wang Xiaoying, Li Si, Guan Yunlong, Xu Changwu, Zhang Bofang, Yang Shuo, Hao Xingjie, Chen Jing
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
Cardiovascular Research Institute of Wuhan University, Wuhan, China.
Prev Med Rep. 2024 Aug 10;46:102853. doi: 10.1016/j.pmedr.2024.102853. eCollection 2024 Oct.
To prospectively assess the individual and joint effects of birth weight and the life's essential 8 (LE8)-defined cardiovascular health (CVH) on myocardial infarction (MI) risk in later life.
In 144,803 baseline MI-free participants who were recruited in the UK Biobank cohort between 2006 and 2010, Cox proportional hazard models were used to estimate the associations of birth weight, LE8 score, and their interactions with incident MI. LE8 was defined on the basis of diet, physical activity, nicotine exposure, sleep health, body mass index, blood pressure, blood glucose, and blood lipids.
Low birth weight was associated with higher risk of MI [hazard ratio (HR) 1.17, 95% confidence interval 1.02-1.35, = 0.025], while no significant correlation between high birth weight and MI was observed after adjustment. Low CVH was associated with higher MI risk [HR 6.43 (3.71-11.15), < 0.001). Participants with low birth weight and low CVH (vs. participants with normal birth weight and high CVH) had HR of 5.97 (2.94-12.14) for MI incidence. The relative excess risk due to interaction of low birth weight and low CVH on MI was -4.11 (-8.12, -0.11), indicating a negative interaction on an additive scale. A consistent decreasing trend of MI risk along with increased LE8 score was observed across all three birth weight groups.
Low birth weight was associated with increased MI risk, emphasizing the importance of the prenatal factor in risk prediction and prevention of MI. Improving LE8 can mitigate MI risk attributed to low birth weight.
前瞻性评估出生体重和生命必需的8项（LE8）定义的心血管健康（CVH）对晚年心肌梗死（MI）风险的个体及联合影响。
在2006年至2010年英国生物银行队列招募的144,803名基线无MI参与者中，使用Cox比例风险模型估计出生体重、LE8评分及其相互作用与新发MI的关联。LE8是根据饮食、身体活动、尼古丁暴露、睡眠健康、体重指数、血压、血糖和血脂定义的。
低出生体重与MI风险较高相关[风险比（HR）1.17，95%置信区间1.02 - 1.35，P = 0.025]，而调整后未观察到高出生体重与MI之间存在显著相关性。低CVH与较高的MI风险相关[HR 6.43（3.71 - 11.15），P < 0.001]。低出生体重和低CVH的参与者（与正常出生体重和高CVH的参与者相比）MI发生率的HR为5.97（2.94 - 12.14）。低出生体重和低CVH对MI相互作用导致的相对超额风险为 - 4.11（-8.12，-0.11），表明在相加尺度上存在负相互作用。在所有三个出生体重组中均观察到MI风险随LE8评分增加呈一致下降趋势。
低出生体重与MI风险增加相关，强调了产前因素在MI风险预测和预防中的重要性。改善LE8可减轻低出生体重所致的MI风险。
