Sex Differences in Cardiovascular Risk Profile From Childhood to Midlife Between Individuals Who Did and Did Not Develop Diabetes at Follow-up: The Bogalusa Heart Study
Sex Differences in Cardiovascular Risk Profile From Childhood to Midlife Between Individuals Who Did and Did Not Develop Diabetes at Follow-up: The Bogalusa Heart Study
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随访时患糖尿病和未患糖尿病的个体从童年到中年心血管风险状况的性别差异：Bogalusa 心脏研究
DOI：
10.2337/dc18-2029
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发表时间：
2019-04-01
期刊：
影响因子：
16.2
通讯作者：
Bazzano, Lydia
中科院分区：
文献类型：
--
作者：
Du, Tingting;Fernandez, Camilo;Bazzano, Lydia
目的：儿童期和青年期可能是心血管危险因素（CVRF）及其累积暴露为未来慢性病风险奠定基础的时期。我们检查了随访时发生和未发生糖尿病的男性和女性儿童期以来CVRF的纵向负担。研究设计和方法：我们纳入了1,530名参与者（平均[SD]随访时间为33.1 [8.2]年），他们参加了博加卢萨心脏研究，并从儿童时期开始至少接受了四次检查（首次检查时的平均年龄[SD]为9.4 [3.1]岁）。使用生长曲线下面积作为自儿童期以来CVRF累积暴露的指标。结果：在儿童期，随访时发生和未发生糖尿病的男孩和女孩的CVRF相似。然而，随着时间的推移，从血糖正常到糖尿病的转变过程中，女性在总胆固醇（TC）、低密度脂蛋白胆固醇（LDL）和空腹血糖（FPG）方面经历了更大的不利变化。（早在23.5岁时就注意到，并在整个成年期一直持续到诊断为糖尿病的年龄）;从童年到中年，暴露于BMI、TC、LDL胆固醇和FPG的负担更高;在同一过渡期内，儿童期以来BMI、TC、LDL胆固醇和FPG的变化率比男性更大（交互作用P值<0.05）。结论：女性与糖尿病诊断相关的CVRF暴露和负担更大，这可能有助于解释糖尿病作为女性心血管事件的主要风险因素对女性的影响大于男性。
OBJECTIVE Childhood and young adulthood may represent time periods in which cardiovascular risk factors (CVRFs) and their cumulative exposure lay the foundation for future risk of chronic diseases. We examined the longitudinal burden of CVRFs since childhood in men and women in whom diabetes did and did not develop at follow-up. RESEARCH DESIGN AND METHODS We included 1,530 participants (mean [SD] follow-up time 33.1 [8.2] years), who participated in the Bogalusa Heart Study and had been examined at least four times starting in childhood (mean age [SD] at first examination 9.4 [3.1] years). The area under the growth curve was used as a measure of cumulative exposure to CVRFs since childhood. RESULTS In childhood, boys and girls in whom diabetes did and did not develop at follow-up had similar CVRFs. Yet, over time, women during the transition from normoglycemia to diabetes experienced greater adverse changes in total cholesterol (TC), LDL cholesterol, and fasting plasma glucose (FPG) (noted as early as 23.5 years old and persisting across adulthood up to the age of the diagnosis of diabetes); a higher burden of exposure to BMI, TC, LDL cholesterol, and FPG from childhood to midlife; and a greater change in rates of BMI, TC, LDL cholesterol, and FPG since childhood than men during the same transition (interaction P values <0.05). CONCLUSIONS The greater exposure of women to and burden of CVRFs associated with diagnosis of diabetes may help to explain the stronger impact of diabetes as a major risk factor for cardiovascular events in women compared with men.