Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood: The Bogalusa Heart Study
Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood: The Bogalusa Heart Study
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DOI：
10.1001/archinte.154.16.1842
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发表时间：
1994-01-01
影响因子：
--
通讯作者：
Berenson, Gerald S.
中科院分区：
文献类型：
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作者：
Bao, Weihang;Srinivasan, Sathanur R.;Berenson, Gerald S.
背景：已知心血管危险因素会随着时间的推移而持续存在，并在儿童和成年期聚集。对多种心血管危险因素的聚集持续性知之甚少，这些危险因素包括收缩压、总胆固醇与高密度脂蛋白胆固醇的比率以及从儿童到青年的血浆胰岛素的不良水平。研究方法：在一项心血管风险的社区研究中，对1176名基线年龄为5至17岁的个体（52%女性，44%黑人）进行了8年的随访。结果如下：计算为收缩压、胰岛素水平和总高密度脂蛋白胆固醇比的种族、性别和年龄特异性排名的总和，多重风险指数显示在所有四个种族性别组中追踪（第1年与第8年的相关性，0.54至0.67）。总体多风险指数跟踪相关性的大小（r= 0.64）显著强于单个风险因素（r= 0.34至0.57）。在最初处于多重风险指数最高五分位数的受试者中，61%的人在8年后仍然保持在那里。多重风险指数的追踪随着年龄和体重指数（体重/（身高-3））的增加而逐渐增加。在逐步回归分析中，基线多重风险指数评分、基线重量指数、重量指数变化和身高变化可预测随访时的多重风险指数评分。这些预测因子解释了种族-性别组中多个风险指数评分的45%至60%的变异性。结论：从童年到成年，多种心血管风险聚集的持续存在以及肥胖在这方面的影响表明，需要采取预防措施，在生命早期培养健康的生活方式。
Background: Cardiovascular risk factors are known to persist over time and to cluster both in childhood and adulthood. Less is known about the persistence of clustering of multiple cardiovascular risk factors comprising adverse levels of systolic blood pressure, the ratio of total cholesterol to high-density lipoprotein cholesterol, and plasma insulin from childhood to young adulthood. Methods: In a community study of cardiovascular risk, 1176 individuals (52% female, 44% black) aged 5 through 17 years at baseline were followed up for 8 years. Results: Calculated as sum of the race-, sex-, and age-specific rankings of systolic blood pressure, insulin level, and total to high-density lipoprotein cholesterol ratio, the multiple risk index was shown to track in all four race-sex groups (year 1 vs year 8 correlations, .54 to .67). The magnitude of the overall multiple risk index tracking correlation (r=.64) was significantly stronger than that noted for individual risk factors (r=.34 to .57). Among subjects who were initially in the highest quintile of the multiple risk index, 61% remained there 8 years later. Tracking of the multiple risk index increased progressively with age and ponderal index (weight/(height-3)). In a stepwise regression analysis, baseline multiple risk index score, baseline ponderal index, change in ponderal index, and change in height were predictive of the multiple risk index score on follow-up. These predictors explained 45% to 60% of the variability in multiple risk index scores among the race-sex groups. Conclusions: The persistence of multiple cardiovascular risk clustering from childhood to adulthood and the impact of obesity in this regard point to the need for preventive measures aimed at developing healthy lifestyles early in life.