(CHD ), (Β= , P < 0101) ; P I P I ( IGT ) (T G) (LDL 2C) CHD R R R ,, P < 0101)

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1 A CTA A CAD EM IA E M ED IC INA E S IN ICA E V o l. 21, N o. 6 D ecem ber, 1999 # α (, ) (CHD ) (Β= , P < 0101) ; (P I),, (P I 24 kggm 3 ) OR (odds ratio) P I> 28 kggm ; ( IGT ) P I ( ) (, P < 0101) (T G) P I ( P < 0101, P < 0101, P < 0105), (HDL 2C) ( P < 0105, P < 0101) CHD (TC) (LDL 2C), T G HDL 2C R R R ,, (CHD ), g CHD [ 1 3 ] [ 4 ], ,, 725 (38% ), 628 (87% ) α M RC, Southamp ton U niversity ; 3 ; 3 3 ; #, :,

2 6 467 : (B IP), (ponderal index P I, : kggm 3 ) : (FG) (F IS) (TC) (HDL 2C) (LDL 2C) (T G) 11 ( FG= 817 mm o lgl ), 617 (O GT T ), 120 m in, 616 O GT T M edgen ix TC HDL 2C T G, LDL 2C F riedew ald (ECG) : 5 m in, ECG D inam ap TM , (SBP) (DBP) 3, (BM I) (% W HR ) CM S W eigh ting Equ ip L TD,, 10 1 : RO SE, (, ) CHD (CHD Index) :, ECG Q gq S (121, 12 2), RO SE,, ECG ST 2T (421, 422 ), CHD Index : W HO, 2 h 1111 mm o lgl (DM ), mm o lgl ( IGT ) < 718 mm o lgl (N GT ) : SBP 160 mm H g DBP 95 mm H g, : (1 = 715 g ) (< 5 g ) (5 15 g ) ( 15 g ) T G, t L og istic, SPSSgPC 810 CHD, BM I 2 628, 1 ( ) g ( ) cm ( ) cm, (P > 0105) CHD index CHD Index 2840 g, (n= 11) (3150 g), (n= 617) (P < 0101) L ogistic 2

3 (x θ s) Table 1 Body m easurem ents in adulthood and at birth fo r 628 subjects M en (n= 309) W om en (n= 319) st ne mer usae mtl ud A A ge H eigh t (cm ) W eigh t (kg) Body m ass index (kggm 2 ) W aistgh ip ratio (% ) % of current cigarette smokers % of heavy drinkers ezis htri B B irthw eight (g) C row n2heel length (cm ) Ponderal index (kggm 3 ) H ead circum ference (cm ) B iparietal diam eter (cm ) P lacental w eight (g) Gestation (days) L ogistic Table 2 R esults by m ultivariate logistic regression analysis V ariables Β S E of Β X 2 P W aistgh ip ratio (% ) Sex Gestation (day) Fasting insulin (pmo lgl) IGT Systo lic BP (mmh g) < B irth w eight (g) D ependent variable= CHD index (0= negative, 1= po sitive) ; 3 1= m ale, 2= fem ale; 3 3 0= N GT, 1= IGT; Β: partial regression P I 3 4 SBP DBP P I ( P < 0105, P < 01001), SBP B IP ( P < 0101) IGT 2 h, IGT P I 3 4, F IS 2 h ( P < 01001, P < 0105, P < 0101)

4 Table 3 T he relationsh ip of co ronary risk facto rs and birth w eigh t B irth w eigh t (kg) To tal P 3 R isk facto rs 2. 5 (n= 44) (n= 184) (n= 284) > 3. 5 (n= 115) (n= 627) Fo r trend Systo lic BP (mmh g) D iasto lic BP (mmh g) Fasting gluco se (mmo lgl ) m in Gluco se (mmo lgl ) Fasting insulin (pmo lgl ) < m in Insulin (pmo lgl ) T G (mmo lgl ) < TC (mmo lgl ) LDL 2C (mmo lgl ) HDL 2C (mmo lgl ) A djusted fo r sex and BM I; BP: blood p ressure; T G: triglyceride; TC: to tal cho lestro l; LDL 2C: low density lipop ro tein cho lestero l; HDL 2C: h igh density lipop ro tein cho lestero l 4 P I IGT OR Table 4 O dds ratio s fo r hypertension and IGT acco rding to w eigh t and ponderal index at birth B irth size B irthw eight (kg) H ypertension OR 3 (95% C I) IGT OR 3 (95% C I ) (1. 1, 9. 0) 2. 5 (1. 1, 5. 6) (0. 7, 3. 8) 1. 7 (1. 0, 3. 1) (0. 5, 2. 5) 1. 0 (0. 6, 1. 8) > Ponderal index (kggm 3 ) (1. 9, 18. 5) 1. 8 (1. 0, 3. 4) (1. 4, 12. 3) 1. 3 (0. 8, 2. 3) (0. 8, 7. 6) 0. 9 (0. 5, 1. 5) > A djust fo r sex and BM I; OR : odds ratio 3 T G P I ( P < 0101, P < 0105) ; HDL 2C ( P < 0101) TC LDL 2C

5 CHD RO SE ECG, CHD index,, CHD index IGT CHD,, IGT T G HDL 2C CHD,, [ 1 3, 5 ], P I,,,, ;,,,,,,,,,,,, CHD,,, CHD, CHD, CHD [ 4 ], CHD CHD,, CHD [ : Barker DJP, L aw Catherine, O smond C live, Stein C laudia, Cox V anessa ; ( ) ( ) ( ) ] 1 Barker DJP. Fetal o rigins of co ronary heart disease. BM J, 1995, 311: L aw CM, de Sw iet M,O smond C, et al. Initiation of hypertension in utero and its amp lification th rough2

6 6 471 out life. BM J, 1993, 306: H ales CN,Barker DJP, C lark PM S, et al. Fetal and infant grow th and impaired gluco se to lerance at age 64. BM J, 1991, 303: W u Zhao su, Yao Chonghua, Zhao Dong, et al. M ultip rovincial monito ring of trends and determ inants in cardiovascular disease (Sino2M ON ICA p ro ject) 2g. R esult of risk facto r monito ring. Ch in J Cardio l, 1997, 25: R ich EJ, StampferM,M anson J, et al. B irthw eigh t breastfeeding and the risk of co ronary heart disease in nurses health study. Am J Ep idem io l, 1995, 141: S78 The Rela tion of Feta l Growth and the B iolog ica l R isk Factors of Coronary Heart D isea se M i J ie # Zhang Konglai L iu Shanying Xu Kongjian L iu Jun, et a l (D epartm ent of Ep idem io logy, Institute of Basic M edical Sciences, CAM S and PUM C, Beijing ) Objective To exam ine the relation sh ip betw een fetal grow th and the b io logical risk fac2 to rs of co ronary heart disease (CHD ) in adu lt life in Ch ina. M ethods Fo llow up study of 628 m en and w om en w ho w ere singleton bo rn du ring w ho se b irth size w ere m ea2 su red in detail. Results D ecreasing b irth w eigh t increased the p robab ility of m yocardial is2 chaem ic sym p tom related to CHD (Β= , P < 0101). T he O dds ratio (OR ) related to hyperten sion increased w ith decreasing b irth w eigh t and ponderal index (P I, kggm 3 ). T he OR w ere 519 in peop le w ho se P I w ere 24 kggm 3 o r less com pare to peop le w ho se P I w ere m o re than 28 kggm 3. T he OR related to im paired gluco se to lerance ( IGT ) also increased w ith de2 creasing b irth w eigh t and P İ In su lin resistance, rep resen ted by fast in su lin, ro se w ith de2 creasing b irth w eigh t and head circum ference (fo r trend, all P < 0101). Serum T G concen tra2 tion sign ifican tly ro se w ith decreasing b irth w eigh t, P I and head circum ference (fo r trend, P < 0101, P < 0101, P < 0105), w h ile HDL 2C ro se w ith increasing b irth w eigh t and head cir2 cum ference (fo r trend, P < 0105, P < 0101). A ll above m en tioned relation s betw een b irth size and the level of risk facto rs du ring adu lthood w ere indep enden t of gesta t ion and adu lt lifestyle. Conclusion s In Ch ina, low b irth m easu rem en ts w h ich rep resen t the fetal grow th retardation m igh t con tribu te to the p resen t of b io logical risk facto rs of co ronary heart disease du ring adu lthood, such as hyperten sion, diabetes, in su lin resistance, h igh serum triglyceride and low HDL 2C. Key words fetal grow th; birth size; co ronary heart disease; risk facto r; fo llow 2up study α ( ) α # Co rresponding autho r