Pediatric triglycerides predict cardiovascular disease events in the fourth to fifth decade of life.
Pediatric triglycerides predict cardiovascular disease events in the fourth to fifth decade of life.
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DOI：
10.1016/j.metabol.2009.04.009
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发表时间：
2009-09
影响因子：
9.8
通讯作者：
Wang, Ping
中科院分区：
文献类型：
--
作者：
Morrison, John A.;Glueck, Charles J.;Horn, Paul S.;Yeramaneni, Samrat;Wang, Ping
为了评估儿科血脂与随后的心血管疾病(CVD)之间的关系，我们在1973-1976年首次研究的学龄儿童中进行了22-31年的随访研究(1998-2003年)。随访包括53%符合条件的既往受试者。我们比较了19例发生≥-1心血管事件的儿童和成人的体重(kg/m2)和血脂水平。入院时平均年龄为12.3±3.3岁，随访时为38.5±3.8岁。首次发生心血管事件的平均年龄为37.1±4.9岁。我们研究的主要新发现是，儿童时期的甘油三酯(TG)与青壮年心血管疾病有一致且独立的关联。儿童和成人甘油三酯的分布均向高水平移动。在19例中，7例(37%)为儿童期TG>；儿科95百分位数(15 3 mg/dl)，其中6例成人随访时TG升高(≥15 0 mg/dl)。总体而言，61%的病例成年后有高甘油三酯。在调整了年龄、性别和种族后，通过方差分析，病例在儿童期和成年期都有较高的甘油三酯水平。使用Bootstrap方法和Cox比例风险分析，以性别、种族、儿童体重指数、低密度脂蛋白、对数高密度脂蛋白、对数甘油三酯、成人吸烟和2型糖尿病为解释变量，预测队列中的心血管疾病。儿童时期的甘油三酯是青壮年心血管疾病危险(危险比5.35，自然对数每增加1个单位95%可信区间1.69~20.0)和成人2型糖尿病(危险比19.4，95%可信区间4.24~114.2)的显著独立解释变量。儿童高甘油三酯血症似乎是一种重要的、独立的、潜在可逆的与青年心血管疾病相关的疾病。
To assess relationships between pediatric lipids and subsequent cardiovascular disease (CVD) in the 4th-5th decades, we conducted 22-31 year follow-up studies (1998-2003) in former schoolchildren first studied in 1973-1976. The follow-up included 53% of eligible former subjects. We compared pediatric and adult body mass (kg/m2) and lipids in 19 cases with ≥1 CVD event and in 789 CVD event-free subjects. Mean ± SD age was 12.3 ± 3.3 at entry and 38.5 ± 3.8 years at follow-up. Mean age at the first CVD event was 37.1 ± 4.9 years. The major novel finding of our study was that childhood triglycerides (TG) were consistently and independently associated with young adult CVD. The distributions of both childhood and adult TG were shifted to higher levels in the cases than controls. Of the 19 cases, 7 (37%) had childhood TG > the pediatric 95th percentile (153 mg/dl), and 6 of these 7 had high TG (≥ 150 mg/dl) at adult follow-up. Overall, 61% of cases had high TG as adults. After adjusting for age, sex, and race, by analysis of variance, cases had higher TG levels both in childhood and in young adulthood. A bootstrapping method and Cox’s proportional hazard analysis was used to predict CVD in the cohort with explanatory variables sex, race, and childhood BMI, LDL, log HDL cholesterol, and log TG, and adult cigarette smoking and type 2 diabetes. Childhood TG was a significant, independent, explanatory variable for young adult CVD hazard (hazard ratio 5.35, 95% CI 1.69-20.0 for each 1 unit increasing in natural logarithm scale) along with adult type 2 diabetes (hazard ratio 19.4, 95% CI 4.24-114.2). Pediatric hypertriglyceridemia appears to be a significant, independent, potentially reversible correlate of young adult CVD.
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DOI：
10.1161/atvbaha.108.163329
发表时间：
2008-05-01
影响因子：
8.7
作者：
Juonala, Markus;Viikari, Jorma S. A.;Raitakari, Olli T.
通讯作者：
Raitakari, Olli T.
影响因子：
37.8
作者：
Davis, PH;Dawson, JD;Lauer, RM
通讯作者：
Lauer, RM
影响因子：
37.8
作者：
Crouse, JR;Tang, R;Mercuri, M
通讯作者：
Mercuri, M
影响因子：
2.9
作者：
Eisenmann, JC;Welk, GJ;Blair, SN
通讯作者：
Blair, SN
影响因子：
4.9
作者：
Freedman, D. S.;Patel, D. A.;Berenson, G. S.
通讯作者：
Berenson, G. S.