Hulman S, Kushner H, Katz S, Falkner B
Albert Einstein Medical Center, Biomedical Computer Research Institute, Krogman Growth Center, University of Pennsylvania, Allegheny University, Philadelphia 19141-3098, USA.
J Pediatr. 1998 Jan;132(1):90-7. doi: 10.1016/s0022-3476(98)70491-3.
Recent retrospective studies of older adults have demonstrated a correlation between lower birth weight and hypertension and insulin resistance. We tested this finding in our sample of urban African Americans with prospective data on growth and blood pressure and also tested other variables (in addition to birth weight) for their relationship to adult cardiovascular risk.
A prospective study of birth weight, growth, and blood pressure (Philadelphia Perinatal Collaborative Project) followed a sample of 137 African Americans, with nine examinations from birth through 28.0 +/- 2.7 years. Metabolic measurements (oral glucose tolerance testing, euglycemic hyperinsulinemic clamp, and plasma lipid concentration) were performed on the subjects as adults. Bivariate correlations among parameters were computed using the Pearson r. The chi-squared statistic was used to determine associations of outcomes with birth weight. Stepwise multiple linear regressions were computed using newborn, early childhood, adolescent, and young adult parameters to predict adult outcomes.
Birth weight and blood pressure at age 28 years are not correlated (Pearson r = 0.06). Birth weight is also unrelated to adult obesity. However, weight at 0.3 years and after and body mass index at 7 years and after are correlated with adult weight. Furthermore, weight at age 14 years is significantly negatively correlated with measures of insulin-stimulated glucose use, indicating that obese adolescents may be at greater risk than nonobese adolescents for development of non-insulin dependent diabetes in adulthood.
We found no relationship between birth weight and adult outcomes pertaining to cardiovascular risk in this sample of adult African Americans. However, we did find evidence that somatic growth (body weight and body mass index) is significantly related to obesity and attenuated insulin-stimulated glucose utilization in adulthood. These findings indicate that the origins of adult cardiovascular disease are related to somatic growth, but not intrauterine growth, and are evident during childhood.
近期针对老年人的回顾性研究表明，低出生体重与高血压及胰岛素抵抗之间存在关联。我们在有生长和血压前瞻性数据的城市非裔美国人样本中验证了这一发现，并测试了其他变量（除出生体重外）与成人心血管风险的关系。
一项关于出生体重、生长和血压的前瞻性研究（费城围产期协作项目）追踪了137名非裔美国人样本，从出生到28.0±2.7岁进行了9次检查。成年后对受试者进行了代谢测量（口服葡萄糖耐量试验、正常血糖高胰岛素钳夹试验和血浆脂质浓度测定）。使用Pearson相关系数r计算参数之间的双变量相关性。卡方统计量用于确定结果与出生体重的关联。使用新生儿、幼儿期、青少年期和青年期参数进行逐步多元线性回归，以预测成人结果。
28岁时的出生体重与血压无相关性（Pearson相关系数r = 0.06）。出生体重也与成人肥胖无关。然而，0.3岁及以后的体重以及7岁及以后的体重指数与成人体重相关。此外，14岁时的体重与胰岛素刺激的葡萄糖利用指标显著负相关，表明肥胖青少年在成年后患非胰岛素依赖型糖尿病的风险可能高于非肥胖青少年。
在这个成年非裔美国人样本中，我们发现出生体重与成人心血管风险相关结果之间没有关系。然而，我们确实发现有证据表明，躯体生长（体重和体重指数）与成年期肥胖及胰岛素刺激的葡萄糖利用减弱显著相关。这些发现表明，成人心血管疾病的起源与躯体生长有关，而非子宫内生长，且在儿童期就已显现。
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