Metabolic syndrome variables at low levels in childhood are beneficially associated with adulthood cardiovascular risk - A Bogalusa heart study
Metabolic syndrome variables at low levels in childhood are beneficially associated with adulthood cardiovascular risk - A Bogalusa heart study
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DOI：
10.2337/diacare.28.1.126
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发表时间：
2005-01-01
期刊：
影响因子：
16.2
通讯作者：
Berenson, GS
中科院分区：
文献类型：
--
作者：
Chen, W;Srinivasan, SR;Berenson, GS
目的：大多数流行病学研究都集中在代谢综合征对心血管疾病的不良影响上。然而，关于代谢综合征变量在儿童期处于有利水平的聚类与成年期心血管风险测量之间的关系的信息尚不清楚。研究设计和方法：研究队列包括1474人（552名黑人和922名白人），这些人在1982-2003年期间在路易斯安那州的Bogalusa接受了儿童期（4-17岁）和成年期（19-41岁）的心血管危险因素检查，平均随访时间为15.8年。结果：在儿童时期，9.0%的队列在BMI、胰岛素抵抗、收缩压和总胆固醇与高密度脂蛋白比值的稳态模型评估的底部四分位数显示出三或四标准风险变量的聚类。聚类显著高于单因素预测（P < 0.01）。与底部四分位数聚集小于三个风险变量的儿童相比，这些儿童成年后代谢综合征的患病率较低（聚集在顶部四分位数）（3.8%对14.6%,P < 0.001）。儿童期低水平风险变量聚类的较高患病率与父母冠心病（9.4%比5.0%,P = 0.024）和高血压（10.5%比6.6%,P = 0.012）的阴性病史相关。成年后颈动脉内膜-中膜厚度的平均值随着儿童时期聚集在底部四分位数的风险变量数量的增加而下降（趋势P = 0.013）。结论：儿童期两个水平的代谢综合征变量与成年期较低的心血管风险相关。
OBJECTIVE - Most epidemiologic studies have focused on the adverse impact of the metabolic syndrome on cardiovascular (CV) disease. However, information on the relationship between the clustering of metabolic syndrome variables at favorable levels in childhood and the measures of CV risk in adulthood is not known.RESEARCH DESIGN AND METHODS- The study cohort included 1,474 individuals (552 blacks and 922 whites) who were examined for CV risk factors in childhood (aged 4-17 years) and again in adulthood (aged 19-41 years) in Bogalusa, Louisiana, during 1982-2003, with an average follow-up period of 15.8 years.RESULTS- In childhood, 9.0% of the cohort displayed clustering of three- or four-criterion risk variables at the bottom quartiles of BMI, homeostasis model assessment of insulin resistance, systolic blood pressure, and total-to-HDL cholesterol ratio. The clustering was significantly higher than expected by chance alone (P < 0.01). These children, compared with those having clustering of less than three risk variables at the bottom quartiles, had a lower prevalence of metabolic syndrome in adulthood (clustering at top quartiles) (3.8 vs. 14.6%, P < 0.001). A higher prevalence of clustering of risk variables at low levels in childhood was associated with negative parental histories of coronary heart disease (9.4 vs. 5.0%, P = 0.024) and hypertension (10.5 vs. 6.6%, P = 0.012). Mean values of carotid intima-media thickness in adulthood decreased with an increasing number of risk variables clustering at the bottom quartiles in childhood (P for trend = 0.013).CONCLUSIONS- The constellation of metabolic syndrome variables at tow levels in childhood is associated with lower measures of CV risk in adulthood.