Childhood risk factors predict cardiovascular disease, impaired fasting glucose plus type 2 diabetes mellitus, and high blood pressure 26 years later at a mean age of 38 years: the Princeton-lipid research clinics follow-up study.
Childhood risk factors predict cardiovascular disease, impaired fasting glucose plus type 2 diabetes mellitus, and high blood pressure 26 years later at a mean age of 38 years: the Princeton-lipid research clinics follow-up study.
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DOI：
10.1016/j.metabol.2011.08.010
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发表时间：
2012-04
影响因子：
9.8
通讯作者：
Wang, Ping
中科院分区：
文献类型：
--
作者：
Morrison, John A.;Glueck, Charles J.;Wang, Ping
评估儿科风险因素是否可预测年轻人的心血管疾病（CVD）、空腹血糖受损（IFG）+2型糖尿病（T2 DM）和高血压（HBP）。对909名公立教区郊区小学儿童进行了前瞻性随访，首次研究年龄为6-18岁，26年后平均年龄为38岁。儿童甘油三酯（TG）、血压、低密度脂蛋白胆固醇（LDLC）、体重指数（BMI）、葡萄糖高于和高密度脂蛋白胆固醇（HDL）低于既定的儿童临界值、沿着种族、吸烟、CVD家族史、2型糖尿病和高血压被评估为年轻成人CVD的决定因素，复合变量包括IFG +2型糖尿病和高血压。通过逐步logistic回归分析，成人CVD（19例是，862例否）与儿童高TG相关，比值比（OR）为5.85，95%置信区间（CI）为2.3-14.7。年轻成人CVD的儿童先证者的高TG是家族性的，并且与其高TG父母的早期CVD相关。成人IFG + T2 DM（114例是，535例否）与父母T2 DM（OR 2.2，95% CI 1.38-3.6）、儿童期高血糖（OR 4.43，95% CI 2-9.7）和儿童期吸烟（OR 1.64，95% CI 1.03-2.61）相关。成人HBP（133例是，475例否）与儿童高BMI（OR 2.7，95% CI 1.7-4.3）和HBP（OR=2.5，95% CI 1.5-4.3）相关。儿童风险因素与年轻成人CVD、IFG+ T2 DM和HBP显著独立相关。确定儿童CVD、IFG+ T2 DM和HBP的风险因素有助于启动一级预防计划，以减少成人CVD、IFG+ T2 DM和HBP的发生。
Assess whether pediatric risk factors predict cardiovascular disease (CVD), impaired fasting glucose (IFG) + type 2 diabetes (T2DM), and high blood pressure (HBP) in young adulthood. Prospective follow-up of 909 public-parochial suburban schoolchildren first studied at ages 6–18 and 26 years later at mean age 38. Pediatric triglycerides (TG), blood pressure, LDL cholesterol (LDLC), BMI, and glucose above and HDL cholesterol (HDLC) below established pediatric cutoffs, along with race, cigarette smoking, family history of CVD, T2DM, and HBP were assessed as determinants of young adult CVD, a composite variable including IFG + T2DM, and HBP. By stepwise logistic regression, adult CVD (19 yes, 862 no) was associated with pediatric high TG, odds ratio (OR) 5.85, 95% confidence intervals (CI) 2.3–14.7. High TG in pediatric probands with young adult CVD was familial, and was associated with early CVD in their high TG parents. Adult IFG + T2DM (114 yes, 535 no) was associated with parental T2DM (OR 2.2, 95% CI 1.38–3.6), high childhood glucose (OR 4.43, 95% CI 2–9.7), and childhood cigarette smoking (OR 1.64, 95% CI 1.03–2.61). Adult HBP (133 yes, 475 no) was associated with pediatric high BMI (OR 2.7, 95% CI 1.7–4.3) and HBP (OR=2.5, 95% CI 1.5–4.3). Pediatric risk factors are significantly, independently related to young adult CVD, IFG+T2DM, and HBP. Identification of pediatric risk factors for CVD, IFG+T2DM, and HBP facilitates initiation of primary prevention programs to reduce development of adult CVD, IFG+T2DM, and HBP.
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