Tang Fengyuan, Yang Wenqianzi, Wu Weijia, Jin Shengxuan, Zhen Xuemei, Dong Hengjin
Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
BMC Public Health. 2025 Sep 2;25(1):3008. doi: 10.1186/s12889-025-24317-4.
The relationships between body size changes and the risk of hypertension and metabolic dysfunction-associated steatotic liver disease (MASLD) are still unclear. This study examined the independent and combined influences of child and adult body size on the risk of adulthood hypertension and MASLD.
We included 226,420 participants from the UK Biobank who were free of hypertension and liver diseases. Child-to-adult body size categories were identified based on self-reported childhood body size and measured BMI in adulthood. Cox proportional hazard regression models were applied to assess the associations between body size categories and the incidence of hypertension and MASLD. Mediation analyses to address the effect of anthropometric measures and metabolic risk factors were also performed.
After a median follow-up of approximately 13 years, 28,662 individuals had developed hypertension (N = 27,624) and/or MASLD (N = 1,692). Low body size in childhood increased the risk of adulthood hypertension and MASLD, regardless of adult body size. Individuals with low child body size and high adult body size exhibited the highest risk for both hypertension (HR 2.01, P < 0.001) and MASLD (HR 3.28, P < 0.001). Individuals who had high child body size but average body size in adulthood had risks of the two diseases that were similar to those of persons who had an average body size consistently (all P > 0.05). Body size changes influenced hypertension through significant natural direct effects and indirect effects via anthropometric and metabolic factors, while their impact on MASLD was primarily mediated by these factors without significant direct effects.
Childhood leanness exacerbates the risk of hypertension and MASLD in adulthood. Within the follow-up period, normal adult body size would mitigate the detrimental effects of childhood obesity. Thus, attention should be given to reinforcing weight management in children by implementing evidence-based strategies.
体型变化与高血压风险以及代谢功能障碍相关脂肪性肝病（MASLD）之间的关系仍不明确。本研究探讨了儿童期和成年期体型对成年期高血压和MASLD风险的独立及综合影响。
我们纳入了英国生物银行的226,420名参与者，这些参与者均无高血压和肝脏疾病。根据自我报告的儿童期体型和成年期测量的体重指数（BMI）确定儿童到成人的体型类别。应用Cox比例风险回归模型评估体型类别与高血压和MASLD发病率之间的关联。还进行了中介分析以探讨人体测量指标和代谢危险因素的影响。
经过约13年的中位随访，28,662人患上了高血压（N = 27,624）和/或MASLD（N = 1,692）。儿童期体型瘦小会增加成年期高血压和MASLD的风险，与成年期体型无关。儿童期体型瘦小且成年期体型高大的个体患高血压（风险比[HR] 2.01，P < 0.001）和MASLD（HR 3.28，P < 0.001）的风险最高。儿童期体型高大但成年期体型中等的个体患这两种疾病的风险与始终体型中等的个体相似（所有P > 0.05）。体型变化通过显著的自然直接效应以及通过人体测量和代谢因素的间接效应影响高血压，而其对MASLD的影响主要由这些因素介导，无显著直接效应。
儿童期消瘦会增加成年期高血压和MASLD的风险。在随访期间，正常的成年体型会减轻儿童期肥胖的有害影响。因此，应通过实施循证策略加强儿童体重管理。
