Adolescent overweight and future adult coronary heart disease
Adolescent overweight and future adult coronary heart disease
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DOI：
10.1056/nejmsa073166
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发表时间：
2007-12-06
影响因子：
158.5
通讯作者：
Goldman, Lee
中科院分区：
文献类型：
--
作者：
Bibbins-Domingo, Kirsten;Coxson, Pamela;Goldman, Lee
背景资料：青少年超重对未来成人冠心病（CHD）的影响尚不清楚。方法：我们根据2000年青少年超重和超重青少年成为肥胖成年人的历史趋势，估计了2020年35岁肥胖人群的患病率。然后，我们使用CHD政策模型（一种针对35岁或35岁以上美国居民的状态转换计算机模拟）来预测2020年至2035年期间CHD的年度超额发病率和患病率、超额CHD事件总数以及CHD和其他肥胖原因导致的超额死亡。我们还模拟了治疗肥胖相关的血压和血脂异常增加的效果。结果：预计到2020年，青少年超重将增加35岁肥胖人群的患病率，男性为30%至37%，女性为34%至44%。由于肥胖的增加，预计在青年期CHD的发病率和CHD事件和死亡总数将增加。随着人口步入中年，预计这一数字无论是绝对值还是相对值都将继续增加。据估计，到2035年，CHD的患病率将增加5%至16%，超过100，000例CHD病例可归因于肥胖的增加。积极的治疗与目前可用的疗法，以扭转可变肥胖相关的危险因素将减少，但不能消除，预计增加的冠心病事件的数量。结论：尽管对未来25年或更长时间的预测存在无数的不确定性，但从目前的数据推断，青少年超重将增加未来年轻人和中年人的冠心病发病率，导致相当大的发病率和死亡率。
Background: The effect of adolescent overweight on future adult coronary heart disease (CHD) is not known.Methods: We estimated the prevalence of obese 35-year-olds in 2020 on the basis of adolescent overweight in 2000 and historical trends regarding overweight adolescents who become obese adults. We then used the CHD Policy Model, a state-transition computer simulation of U.S. residents who are 35 years of age or older, to project the annual excess incidence and prevalence of CHD, the total number of excess CHD events, and excess deaths from both CHD and other causes attributable to obesity from 2020 to 2035. We also modeled the effect of treating obesity-related increases in blood pressure and dyslipidemia.Results: Adolescent overweight is projected to increase the prevalence of obese 35-year-olds in 2020 to a range of 30 to 37% in men and 34 to 44% in women. As a consequence of this increased obesity, an increase in the incidence of CHD and in the total number of CHD events and deaths is projected to occur in young adulthood. The increase is projected to continue in both absolute and relative terms as the population reaches middle age. By 2035, it is estimated that the prevalence of CHD will increase by a range of 5 to 16%, with more than 100,000 excess cases of CHD attributable to the increased obesity. Aggressive treatment with currently available therapies to reverse modifiable obesity-related risk factors would reduce, but not eliminate, the projected increase in the number of CHD events.Conclusions: Although projections 25 or more years into the future are subject to innumerable uncertainties, extrapolation from current data suggests that adolescent overweight will increase rates of CHD among future young and middle-aged adults, resulting in substantial morbidity and mortality.