Childhood Origins for Cardiac Structure and Function

心脏结构和功能的童年起源

• 批准号: 8410261
• 负责人: SHUMEI S SUN
• 金额: $ 69.01万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8410261
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Age; Appearance; Biological Markers; Birth; Blood Pressure; Body Composition; Body Size; Body fat; Cardiac; Centers for Disease Control and Prevention (U.S.); Central obesity; Child; Childhood; Congenital Heart Defects; Consent; Country; Data; Data Set; Derivation procedure; Development; Early identification; Epidemic; Fatty acid glycerol esters; Growth; Height; Hypertension; Individual; Intervention; Lead; Left; Left Ventricular Ejection Fraction; Left Ventricular Mass; Life; Life Style; Longitudinal Studies; Measurement; Measures; Metabolic syndrome; Modeling; Normal Range; Obesity; Participant; Pathologic; Physiological; Population Study; Prevalence; Procedures; Process; Public Health; Relative (related person); Risk; Shortening Fraction; Structure; Thick; Time; Ventricular; age group; base; boys; cationic antimicrobial protein CAP 37; experience; falls; girls; high risk; indexing; normotensive; obesity in children; sex; sexual dimorphism; waist circumference

DESCRIPTION (provided by applicant): The epidemic of childhood obesity that has affected children and adolescents in this country has led to an increased prevalence of hypertension in these age groups. Analyses of the Fels Longitudinal Study (FLS) data set have shown that elevated blood pressure in childhood tracks into adulthood with fidelity and that elevated blood pressure in childhood, even within the range considered to be normal---from the 70th to the 95thpercentiles of the National CDC growth charts (2000)---accurately predict hypertension and the metabolic syndrome in adulthood. In view of the close association of obesity and hypertension and of the association of hypertension with abnormalities of cardiac structure and function, it would be of public health importance to ascertain if childhood obesity predicts abnormalities of cardiac structure and/or function later in life. We are poised to interrogate a portion of the FLS data set to address this question. The pertinent portion of the FLS data set includes serial anthropometric and blood pressure measurements from birth---and body composition measurements from age eight years---through adulthood in 750 participants who consented to undergo echocardiographic studies as adults. Hierarchical and cluster longitudinal modeling procedures will be applied to this unique set of serial measurements to elucidate the relationships between childhood obesity, blood pressure, tempo of maturation, and abnormal cardiac structure and function. The specific aims that we plan to investigate include ascertaining the effects of children's blood pressure, body size, and body composition on (1) blood pressure, (2) cardiac structure, and (3) cardiac function in the same subjects decades later as adults. We have available for analysis more than 750 echocardiographic studies from which to derive the structural measurements of left ventricular mass index (LVMI), interventricular septal thickness (IVST), and relative wall thickness (RWT) and the functional measurements of ejection fraction (EF) and left ventricular shortening fraction (LVSF). These proposed analyses have the potential to quantify risk for hypertension and abnormalities of cardiac structure and function in adulthood given certain values for body size, body composition, and blood pressure in childhood and adolescence, even if these values fall within currently accepted normal values. If we identify biomarkers in children that predict hypertension, and/or abnormal cardiac structure and function in adults, then children with these biomarkers can be evaluated more thoroughly and offered lifestyle and/or pharmacologic interventions before irreversible pathologic changes have occurred. Conversely, our proposed analyses also have the potential to identify a set of ranges of body size, body composition, and blood pressure in childhood and adolescence which are not associated with hypertension or abnormal cardiac structure and function later in life and which can be used to predict a normotensive adulthood, free of cardiac structural or functional abnormalities. PUBLIC HEALTH RELEVANCE: The epidemic of childhood obesity has engendered a rise in prevalence of hypertension in children and adolescents. In view of the associations of obesity with hypertension and of hypertension with abnormal cardiac structure and function, it would be of public health importance to ascertain if childhood obesity predicts abnormalities of cardiac structure and/or function later in life. Our proposed analyses of serial data in the same individuals as children and adults will quantify risk for hypertension and abnormalities of cardiac structure and function in adulthood given certain values for body size, body composition, and blood pressure in childhood and adolescence.

描述（由申请人提供）：影响该国的儿童和青少年的儿童肥胖症流行，导致这些年龄段的高血压患病率增加了。 FELS纵向研究（FLS）数据集的分析表明，儿童期在成年期的血压升高以富裕性和童年的血压升高，即使在被认为是正常的范围内 - 从70th-从70次到95 the the National CDC增长图（2000年）----准确预测了高度高度和掌握综合性的范围。鉴于肥胖和高血压的密切关联以及高血压与心脏结构和功能异常的关联，确定儿童肥胖是否预测心脏结构异常和/或生命后期功能是公共健康的重要性。我们准备询问FLS数据集的一部分以解决此问题。 FLS数据集的相关部分包括从出生开始的串行人体测量和血压测量，以及从八岁开始的身体组成测量值 - 到成年的750名参与者，他们同意接受超声心动图研究。分层和簇纵向建模程序将应用于这一独特的串行测量集，以阐明儿童肥胖，血压，成熟的速度以及异常心脏结构和功能之间的关系。我们计划调查的具体目的包括确定儿童的血压，身体大小和身体成分对（1）血压，（2）心脏结构的影响，以及（3）与成年人几十年后同一受试者的心脏功能。我们可以分析超过750个超声心动图研究，从中可以得出左心室质量指数（LVMI），介入室内厚度（IVST）以及相对壁厚（RWT）的结构测量以及射血分数（EF）和左心室缩短效果（LVSF）的功能测量。这些提出的分析具有量化高血压和心脏结构异常和功能异常的潜力，因为即使这些值在当前接受的正常值范围内，童年和青春期的身体大小，身体组成和血压的某些值也是如此。如果我们确定预测高血压的儿童的生物标志物和/或成年人的心脏结构和功能异常，那么可以更彻底地评估患有这些生物标志物的儿童，并提供生活方式和/或药理学干预措施，然后发生不可逆的病理变化。相反，我们提出的分析也有可能识别一组儿童和青春期的体型，身体成分和血压范围，这些范围与高血压或异常心脏结构和生命后期的异常功能无关，并且可以用于预测正常的繁殖，自由性心动结构或功能性异常。 公共卫生相关性：儿童肥胖症的流行使儿童和青少年的高血压患病率增加。鉴于肥胖与高血压以及高血压与异常心脏结构和功能的关联，确定儿童肥胖是否预测心脏结构异常和/或在生活中的功能是很重要的。我们对与儿童和成人同一个体中序列数据的拟议分析将量化心脏高血压和异常的风险 在成年期的结构和功能给定某些体型，身体成分以及儿童和青春期血压的某些值。