Variabilities in Childhood Cardiovascular Risk Factors and Incident Diabetes in Adulthood: The Bogalusa Heart Study
Variabilities in Childhood Cardiovascular Risk Factors and Incident Diabetes in Adulthood: The Bogalusa Heart Study
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儿童期心血管危险因素的变异性和成年期糖尿病的发生率：Bogalusa 心脏研究
DOI：
10.2337/dc19-0430
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发表时间：
2019-09-01
期刊：
影响因子：
16.2
通讯作者：
Bazzano, Lydia A.
中科院分区：
文献类型：
--
作者：
Du, Tingting;Fernandez, Camilo;Bazzano, Lydia A.
目的 尽管新出现的证据表明，中年或以后人群中心血管危险因素（CVRF）变异性的增加是不良健康结果的可靠预测因子，但尚不清楚儿童或青春期个体内 CVRF 变异性是否是晚年糖尿病的独立预测因子。我们的目的是研究儿童时期 CVRF 变异与以后生活中糖尿病的关系。研究设计和方法 我们纳入了 1,718 名参加 Bogalusa 心脏研究的参与者，他们在儿童时期（4-19 岁）至少接受过四次测量。平均随访期为 20.5 年。使用SD、变异系数、年龄预测值的偏差以及基于儿童期四到八次连续测量的残余SD来计算儿童期个体内CVRF变异性。结果无论使用何种指数，儿童期BMI或HDL胆固醇（HDL-C）变异性的增加与晚年糖尿病风险显着正相关，独立于其各自在儿童期的平均水平和其他可能的混杂因素。在综合分析中，儿童 BMI 变异性高和 HDL-C 变异性高与糖尿病风险的关联程度相似。对潜在的混杂变量进行调整后，其他 CVRF 变异（包括收缩压/舒张压、总胆固醇、甘油三酯和 LDL 胆固醇）与糖尿病没有显着相关性。结论 儿童期 BMI 和 HDL-C 变异性增加是独立于多种危险因素之外的糖尿病发展的重要危险因素，这可能为成人发病糖尿病的儿童起源提供新的见解。
OBJECTIVE Although emerging evidence indicates that increased variability in cardiovascular risk factors (CVRFs) among populations at midlife or later is a reliable predictor of adverse health outcomes, it is unknown whether intraindividual CVRF variability during childhood or adolescence is an independent predictor of later-life diabetes. We aimed to examine the association of CVRF variability during childhood with diabetes in later life. RESEARCH DESIGN AND METHODS We included 1,718 participants who participated in the Bogalusa Heart Study and had measures at least four times during childhood (aged 4–19 years). The mean follow-up period was 20.5 years. Intraindividual CVRF variabilities during childhood were calculated using SD, coefficient of variation, deviation from age-predicted values, and residual SD based upon four to eight serial measurements in childhood. RESULTS Increased variability in BMI or HDL cholesterol (HDL-C) during childhood, irrespective of the indices used, was significantly positively associated with later-life diabetes risk independent of their respective mean levels in childhood and other possible confounding factors. In combined analysis, the magnitude of the association with diabetes risk was similar for high childhood BMI variability and high childhood HDL-C variability. After adjustments for potential confounding variables, other CVRF variabilities including systolic/diastolic blood pressure, total cholesterol, triglycerides, and LDL cholesterol were not significantly associated with diabetes. CONCLUSIONS Increased BMI and HDL-C variabilities during childhood were significant risk factors for the development of diabetes independently of diverse risk factors, which may offer new insights into the childhood origin of adult-onset diabetes.