Childhood CV Risk and Adult CVD Outcomes: an International Long-term Follow-up

儿童心血管风险和成人心血管疾病结果：国际长期随访

• 批准号: 8974859
• 负责人: TRUDY L BURNS
• 金额: $ 255.96万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2019-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8974859
• 关键词: Address; Adolescence; Adolescent; Adult; Adverse effects; Age; Aneurysm; Angina Pectoris; Australia; Blood Pressure; Cardiovascular system; Cause of Death; Cessation of life; Child; Childhood; Cholesterol; Clinic; Clinical Research; Cohort Studies; Collaborations; Coronary heart disease; Data; Development; Diabetes Mellitus; Disease; Enrollment; Ethnic Origin; Event; Finland; Funding; Growth; Health; Heart; Heart Diseases; Heart failure; High Density Lipoprotein Cholesterol; Incidence; Individual; International; Intervention; Iowa; Joints; LDL Cholesterol Lipoproteins; Life; Link; Lipids; Longitudinal Studies; Louisiana; Measurement; Measures; Medical Records; Meta-Analysis; Minnesota; Morbidity - disease rate; Myocardial Infarction; National Heart, Lung, and Blood Institute; Nature; Ohio; Outcome; Participant; Patient Self-Report; Peripheral arterial disease; Preventive measure; Publications; Publishing; Questionnaires; Race; Research; Research Proposals; Risk; Risk Factors; Risk Reduction; Sample Size; Stroke; Structure; Time; Transient Ischemic Attack; Triglycerides; United States National Institutes of Health; Weight; adjudicate; adjudication; cardiovascular risk factor; cohort; data sharing; design; follow-up; indexing; innovation; insight; meetings; member; mortality; novel; response; sex

DESCRIPTION (provided by applicant): The primary objective of this research proposal is to determine the nature of relationships between levels of cardiovascular (CV) risk factors (anthropometrics, lipids, blood pressure) in childhood and CV morbidity and mortality in adulthood. The NHLBI Pediatric CV Risk Reduction Initiative noted that the lack of longitudinal studies linking CV risk factor levels in children to CV endpoints in adulthood is a major clinical research gap that needs to be spanned. This research will close that gap by pooling data on participants from seven major U.S. and international longitudinal cohort studies that were initiated in the 1970s and 1980s. These studies all have measured detailed CV risk factors in childhood, and have follow-up data spanning childhood and adulthood. They have been collaborating since 2009 as the International Childhood Cardiovascular Cohort (i3C) Consortium, with an administrative organization, regular organizational and data sharing meetings, and fifteen joint publications. Specific Aim 1 of this study is to locate the childhood participants of five NIH-funded longitudinal studies in the U.S. (BHS, MUSC, PFS, MCCS, and NGHS) and two international studies (YFS and CDAH); identify incident CV endpoints (coronary heart disease, myocardial infarction, heart failure, peripheral artery disease, and stroke) using self-reported morbidity validated by adjudication of medical records; and identify decedents using the National Death Index and adjudicate cause of death for deceased participants. In Aim 2, these data will be used to address the hypotheses that: 1) Adverse childhood/adolescent (age 3-19) CV risk factor levels (BMI, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, BP) are related to increased incidence of CV endpoints in adulthood.; 2) A CV risk score weighting childhood/adolescent risk factors (BMI, BP, lipids, age, sex and race/ethnicity) is a stronger predictor of adult CV endpoints than any individual risk factor.; and 3) The relationship of individual risk factors or CV risk score with adult CV endpoints becomes stronger with increasing age from childhood (age 3-11) to adolescence (age 11-19). Aim 3 will evaluate the association of CV risk score trajectories on adult CV endpoints, focusing on trajectories during childhood/adolescence (hypothesis 4) and between childhood/adolescence and adulthood (hypothesis 5). The present proposal is innovative in that it assembles, for the first time, a cohort of sufficient size (22,883 anticipated recruitment), with childhood risk factor measurements, and with a duration of follow-up (40 years) that will enable follow-up of participants at ages when CV events occur. It will, therefore, provide novel insights into how childhood risk factors contribute to adult cardiometabolic disease.

描述（由申请人提供）：本研究提案的主要目的是确定儿童期心血管（CV）风险因素（人体测量学、血脂、血压）水平与成年期CV发病率和死亡率之间关系的性质。NHLBI儿科CV风险降低计划指出，缺乏将儿童CV风险因素水平与成年期CV终点联系起来的纵向研究是一个需要跨越的主要临床研究空白。这项研究将通过汇集20世纪70年代和80年代发起的七项主要的美国和国际纵向队列研究的参与者数据来缩小这一差距。这些研究都测量了儿童期详细的CV风险因素，并有跨越儿童期和成年期的随访数据。自2009年以来，他们一直以国际儿童心血管队列（i3 C）联盟的名义进行合作，有一个行政组织，定期组织和数据共享会议，以及15份联合出版物。本研究的具体目标1是在美国找到五个NIH资助的纵向研究的儿童参与者。（BHS、MUSC、PFS、MCCS和NGHS）和两项国际研究（YFS和CDAH）;确定事件CV终点（冠心病、心肌梗死、心力衰竭、外周动脉疾病和卒中）使用通过医疗记录裁定验证的自我报告发病率;并使用国家死亡指数确定死者，并裁定死亡参与者的死亡原因。在目标2中，这些数据将用于解决以下假设：1）不良儿童/青少年（3-19岁）CV风险因素水平（BMI、总胆固醇、LDL胆固醇、HDL胆固醇、甘油三酯、BP）与成年期CV终点发生率增加相关。2)对儿童/青少年风险因素（BMI、BP、血脂、年龄、性别和种族/民族）进行加权的CV风险评分比任何单个风险因素更能预测成人CV终点。和3）个体风险因素或CV风险评分与成人CV终点的关系随着年龄从儿童期（3-11岁）到青春期（11-19岁）的增加而变得更强。目标3将评估CV风险评分轨迹与成人CV终点的相关性，重点关注儿童/青春期（假设4）以及儿童/青春期和成年期（假设5）之间的轨迹。本提案具有创新性，因为它首次收集了足够规模的队列（预计招募22，883人），具有儿童风险因素测量值，并具有随访持续时间（40年），这将使参与者能够在发生CV事件的年龄进行随访。因此，它将为儿童期危险因素如何导致成人心脏代谢疾病提供新的见解。