Frankel S, Elwood P, Sweetnam P, Yarnell J, Smith G D
Department of Social Medicine, University of Bristol.
Public Health. 1996 May;110(3):139-43. doi: 10.1016/s0033-3506(96)80066-7.
To determine the relationships between birthweight, the incidence of coronary heart disease, and a range of coronary heart disease risk factors that operate during adult life.
Cohort study with a 10-year follow-up period.
The town of Caerphilly, South Wales, and five adjacent villages.
1,258 men aged 45-59 at time of recruitment between 1979 and 1983.
All deaths, coronary heart disease deaths, non-fatal CHD events.
The validity of the birthweight data was supported by the strong graded associations between birthweight and anthropometric measures in adulthood, particularly height, body mass index, triceps, skinfold thickness and percentage body fat. An inverse relationship was found between birthweight and incident fatal and non-fatal CHD, (P = 0.01), though no relationship was found between birthweight and all-cause mortality. Amongst the major CHD risk factors, only fibrinogen shows a statistically significant relationship with birthweight (P = 0.008), fibrinogen levels being lower among the men with lower birthweights. When social and biological variables are included in models relating incident CHD and birthweight, the relationship between birthweight and incident fatal and non-fatal CHD remains essentially unchanged.
A graded association between low birthweight and later CHD has been demonstrated in this cohort. This inverse association cannot be explained by the measured social or behavioural variables, or by other risk factors operating in adult life.
确定出生体重、冠心病发病率以及一系列成年期冠心病危险因素之间的关系。
为期10年随访期的队列研究。
南威尔士的卡菲利镇及五个相邻村庄。
1979年至1983年招募时年龄在45 - 59岁之间的1258名男性。
所有死亡、冠心病死亡、非致死性冠心病事件。
出生体重数据的有效性得到了支持，因为出生体重与成年期人体测量指标之间存在强烈的分级关联，尤其是身高、体重指数、肱三头肌、皮褶厚度和体脂百分比。出生体重与致死性和非致死性冠心病发病呈负相关（P = 0.01），不过出生体重与全因死亡率之间未发现关联。在主要的冠心病危险因素中，只有纤维蛋白原与出生体重存在统计学显著关联（P = 0.008），出生体重较低的男性纤维蛋白原水平较低。当将社会和生物学变量纳入冠心病发病与出生体重的相关模型时，出生体重与致死性和非致死性冠心病发病之间的关系基本保持不变。
在该队列中已证实低出生体重与后期冠心病之间存在分级关联。这种负相关无法用所测量的社会或行为变量，或成年期的其他危险因素来解释。
