Clayton Gemma L, Howe Laura D, O'Keeffe Linda M, Lewandowski Adam J, Lawlor Deborah A, Fraser Abigail
Medical Research Council Integrative Epidemiology Unit at the University of Bristol Bristol UK.
Population Health Science, Bristol Medical School University of Bristol Bristol UK.
J Am Heart Assoc. 2025 Feb 4;14(3):e030823. doi: 10.1161/JAHA.123.030823. Epub 2025 Feb 3.
Adults who were born prematurely (<37 weeks' gestation) are at increased cardiovascular disease risk, but it is unclear when in the life course this risk emerges. Our aim was to compare trajectories of multiple cardiometabolic risk factors from childhood to early adulthood between those who had and had not been born preterm.
Multilevel models were used to compare trajectories from early childhood (<9 years) to age 25 years of body mass index, fat and lean mass, systolic and diastolic blood pressure, lipids, glucose, and insulin, between individuals born preterm (N=311-676; range, 25-36 weeks' gestation) and term (N=4973-10 534) in a UK birth cohort study. We also investigated gestational age as a continuum. In children born preterm (versus term), systolic and diastolic blood pressures were higher at age 7 years (mean predicted differences, 0.7 [95% CI, -0.2 to 1.6] mm Hg and 0.6 [95% CI, -0.04 to 1.3] mm Hg, respectively). By age 18 years, the difference in systolic blood pressure persisted (1.9 [95% CI, 0.8-3.1] mm Hg) and in diastolic blood pressure (0.1 [95% CI, -0.7 to 1.0 mm Hg]) disappeared. By age 25 years, this difference in systolic blood pressure began to attenuate towards the null (0.9 [95% CI, -0.5 to 2.3] mm Hg). Participants born preterm (versus term) had lower body mass index between ages 7 and 18 years, but by age 25 years, there was no difference. Fat and lean mass trajectories were consistent with body mass index. High-density lipoprotein cholesterol was higher and triglycerides lower at birth, in those born preterm, but this difference also disappeared by age 25 years. There was no evidence of differences in glucose and insulin.
Few, modest differences in cardiometabolic health were found in those born preterm versus term. All disappeared by age 25 years, except the small difference in systolic blood pressure. Longer follow-up is needed to establish if and when cardiometabolic health trajectories diverge between these 2 groups.
早产（妊娠<37周）出生的成年人患心血管疾病的风险增加，但尚不清楚这种风险在生命历程中的何时出现。我们的目的是比较早产和足月出生者从童年到成年早期多种心脏代谢危险因素的轨迹。
在一项英国出生队列研究中，使用多水平模型比较早产（N = 311 - 676；孕周范围25 - 36周）和足月（N = 4973 - 10534）出生个体从幼儿期（<9岁）到25岁时体重指数、脂肪和瘦体重、收缩压和舒张压、血脂、血糖和胰岛素的轨迹。我们还将胎龄作为一个连续变量进行研究。早产（与足月相比）儿童在7岁时收缩压和舒张压较高（平均预测差异分别为0.7 [95%CI，-0.2至1.6] mmHg和0.6 [95%CI，-0.04至1.3] mmHg）。到18岁时，收缩压差异仍然存在（1.9 [95%CI，0.8 - 3.1] mmHg），而舒张压差异（0.1 [95%CI，-0.7至1.0 mmHg]）消失。到25岁时，收缩压差异开始向零减弱（0.9 [95%CI，-0.5至2.3] mmHg）。早产（与足月相比）参与者在7至18岁之间体重指数较低，但到25岁时，没有差异。脂肪和瘦体重轨迹与体重指数一致。早产出生者出生时高密度脂蛋白胆固醇较高，甘油三酯较低，但这种差异到25岁时也消失了。没有证据表明血糖和胰岛素存在差异。
早产和足月出生者在心脏代谢健康方面存在很少的、适度的差异。到25岁时所有差异都消失了，除了收缩压的微小差异。需要更长时间的随访来确定这两组之间心脏代谢健康轨迹是否以及何时出现分歧。
