Adolescence Risk Factors Are Predictive of Coronary Artery Calcification at Middle Age The Cardiovascular Risk in Young Finns Study
Adolescence Risk Factors Are Predictive of Coronary Artery Calcification at Middle Age The Cardiovascular Risk in Young Finns Study
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DOI：
10.1016/j.jacc.2012.05.045
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发表时间：
2012-10-09
影响因子：
24
通讯作者：
Raitakari, Olli T.
中科院分区：
文献类型：
--
作者：
Hartiala, Olli;Magnussen, Costan G.;Raitakari, Olli T.
Objectives本研究的目的是探讨青少年危险因素在预测冠状动脉钙化（CAC）中的作用。背景：青少年期冠心病危险因素水平升高可预测随后的CAC，独立于从青少年到成年的危险因素水平的变化。分别于1980年（12 ~ 18岁）和2007年测量危险因素水平。结果任何CAC的患病率为19.2%（男性27.9%，女性12.2%）。年龄，收缩压（BP），总胆固醇和低密度脂蛋白胆固醇（LDL-C）在青春期，以及收缩压，总胆固醇，舒张压，和包年吸烟在CAC的受试者比那些没有CAC。青少年LDL-C和收缩压水平预测CAC在成年期独立的27年的变化，这些危险因素。青少年期LDL-C和收缩压增加1-SD的多变量比值比分别为1.34（95%置信区间：1.05 - 1.70; p = 0.02）和1.38（95%置信区间：1.08 - 1.77; p = 0.01）。在青春期暴露于这两种危险因素（定义为等于或高于年龄和性别特异性第75百分位数的值）显著增加CAC的风险（多变量比值比：3. 5 [95%置信区间：1. 7 ~ 7. 2; p = 0.007]）。结论青少年LDL-1水平升高，C和收缩压水平是成年期CAC的独立预测因子，表明青春期危险因素水平在冠心病发病机制中起重要作用。（J Am科尔心脏病学杂志2012;60：1364-70）（C）美国心脏病学会基金会2012年
Objectives The purpose of this study was to examine the roles of adolescence risk factors in predicting coronary artery calcium (CAC).Background Elevated coronary heart disease risk factor levels in adolescence may predict subsequent CAC independently of change in risk factor levels from adolescence to adulthood.Methods CAC was assessed in 589 subjects 40 to 46 years of age from the Cardiovascular Risk in Young Finns Study. Risk factor levels were measured in 1980 (12 to 18 years) and in 2007.Results The prevalence of any CAC was 19.2% (27.9% in men and 12.2% in women). Age, levels of systolic blood pressure (BP), total cholesterol, and low-density lipoprotein cholesterol (LDL-C) in adolescence, as well as systolic BP, total cholesterol, diastolic BP, and pack-years of smoking in adulthood were higher among subjects with CAC than those without CAC. Adolescence LDL-C and systolic BP levels predicted CAC in adulthood independently of 27-year changes in these risk factors. The multivariable odds ratios were 1.34 (95% confidence interval: 1.05 to 1.70; p = 0.02) and 1.38 (95% confidence interval: 1.08 to 1.77; p = 0.01), for 1-SD increase in adolescence LDL-C and systolic BP, respectively. Exposure to both of these risk factors in adolescence (defined as values at or above the age-and sex-specific 75th percentile) substantially increased the risk of CAC (multivariable odds ratio: 3.5 [95% confidence interval: 1.7 to 7.2; p = 0.007]) between groups with no versus both risk factors.Conclusions Elevated adolescence LDL-C and systolic BP levels are independent predictors of adulthood CAC, indicating that adolescence risk factor levels play an important role in the pathogenesis of coronary heart disease. (J Am Coll Cardiol 2012;60:1364-70) (C) 2012 by the American College of Cardiology Foundation