近日，德国莱比锡大学医院Chuang Yang团队研究了妊娠后前1000天糖配给暴露与长期心血管结局。这一研究成果发表在2025年10月22日出版的国际学术期刊《英国医学杂志》上。

为了研究早期的糖配给是否与成年后心血管疾病风险的降低有关，研究组进行了一项自然实验研究，选择英国基于人口的队列。63433 UK Biobank参与者出生于1951年10月至1956年3月之间，无心血管疾病、多胞胎、收养或在英国以外出生。暴露程度是准实验性地根据出生日期与1953年糖配给结束的时间相比较来确定的。使用了来自健康与退休研究和英国老龄化纵向研究的外部验证队列。

主要结局是心血管疾病、心肌梗死、心力衰竭、心房颤动、中风和心血管疾病死亡率，通过相关的健康记录确定。使用Cox和参数风险模型对人口统计学、社会经济、生活方式、父母健康、遗传因素和地理控制因素进行调整，估计风险比。在接受心脏磁共振成像的子集中测量多个心脏参数。

长期摄入糖配给与成年期心血管风险逐渐降低有关。与从未暴露于定量配给的人相比，子宫内暴露1-2年的人心血管疾病的风险比为0.80(95%可信区间（CI） 0.73至0.90)，心肌梗死为0.75(0.63至0.90)，心力衰竭为0.74(0.59至0.95)，心房颤动为0.76(0.66至0.92)，中风为0.69(0.53至0.89)，心血管疾病死亡率为0.73（0.54至0.98）。偶发性糖尿病和高血压共同介导了糖配给与心血管疾病关联的31.1%，而出生体重仅占2.2%。糖配给也与左室卒中容积指数（0.73 (95% CI 0.05至1.41)mL/m2）和射血分数（0.84%,95% CI 0.40%至1.28%）的适度增加有关。

研究结果表明，在出生后1000天进行糖配给与成年后较低的心血管风险和稍有利的心脏指数相关，表明早期糖限制对心血管有长期益处。

附：英文原文

Title: Exposure to sugar rationing in first 1000 days after conception and long term cardiovascular outcomes: natural experiment study

Author: Jiazhen Zheng, Zhen Zhou, Jinghan Huang, Qiang Tu, Haisheng Wu, Quan Yang, Peng Qiu, Wenbo Huang, Junchun Shen, Chuang Yang, Gregory Y H Lip

Issue&Volume: 2025/10/22

Abstract:

Objective To examine whether exposure to sugar rationing during early life is associated with a reduction in the risk of cardiovascular outcomes in adulthood.

Design Natural experiment study.

Setting UK population based cohort.

Participants 63433 UK Biobank participants born between October 1951 and March 1956 without prevalent cardiovascular disease, multiple births, adoption, or birth outside the UK. Exposure was quasi-experimentally assigned on the basis of birth date relative to the end of sugar rationing in 1953. External validation cohorts from the Health and Retirement Study and the English Longitudinal Study of Ageing were used.

Main outcome measures Primary outcomes were incident cardiovascular disease, myocardial infarction, heart failure, atrial fibrillation, stroke, and cardiovascular disease mortality, ascertained through linked health records. Hazard ratios were estimated using Cox and parametric hazard models adjusted for demographic, socioeconomic, lifestyle, parental health, and genetic factors and geographical controls. Multiple cardiac parameters were measured in a subset undergoing cardiac magnetic resonance imaging.

Results Longer exposure to sugar rationing was associated with progressively lower cardiovascular risks in adulthood. Compared with people never exposed to rationing, those exposed in utero plus 1-2 years had hazard ratios of 0.80 (95% confidence interval (CI) 0.73 to 0.90) for cardiovascular disease, 0.75 (0.63 to 0.90) for myocardial infarction, 0.74 (0.59 to 0.95) for heart failure, 0.76 (0.66 to 0.92) for atrial fibrillation, 0.69 (0.53 to 0.89) for stroke, and 0.73 (0.54 to 0.98) for cardiovascular disease mortality. Incident diabetes and hypertension jointly mediated 31.1% of the sugar rationing-cardiovascular disease association, whereas birth weight contributed only 2.2%. Sugar rationing was also associated with a modest increase in left ventricular stroke volume index (0.73 (95% CI 0.05 to 1.41) mL/m2) and ejection fraction (0.84%, 95% CI 0.40% to 1.28%).

Conclusion Exposure to sugar rationing during the first 1000 days of life was associated with lower cardiovascular risks in adulthood and slightly more favourable cardiac indices, suggesting long term cardiovascular benefits of early life sugar restriction.

DOI: 10.1136/bmj-2024-083890

Source: https://www.bmj.com/content/391/bmj-2024-083890