Childhood Antecedents of Adult Cardiometabolic health: A Prospective Study of Low-Income Men

项目总结/摘要 心血管疾病（CVD）和糖尿病是美国成年人死亡的主要原因， 随着疾病的发生，多年来积累的风险，通过各种代谢 途径（肥胖、血脂异常、胰岛素抵抗），免疫因素（例如，系统性 炎症）和血压升高。心血管疾病的发病机制与心脏代谢健康 从童年开始，因此必须确定有助于出现的因素 心脏代谢健康差异。像其他慢性疾病一样，CVD和糖尿病也是 社会经济梯度，出生于 不利的环境。然而，没有前瞻性研究仔细描述 早期社会经济劣势与成人健康之间的联系， 在特定的发展阶段是特别有害的，并描绘发展 可能将经济劣势与心脏代谢疾病（CMD）风险联系起来的突出风险因素。 在家庭压力框架的指导下，我们建议家庭、学校和社区各级 关键发展阶段的因素是社会经济发展的途径， 儿童时期的不利因素影响心脏代谢健康。我们还考虑了儿童的作用- 基于保护性因素，可以缓冲贫困对成人健康结果的影响。 最后，我们探讨了种族和社会经济地位如何相互作用，以形成成年期CMD的风险，以及是否 成年人的健康行为是经济劣势引起更大的健康风险的途径。 CMD倾向。该项目将评估248名不同样本的心血管健康状况。 参加匹兹堡母婴项目的成年男性（31-33岁） （PMCP）。家长项目从低收入家庭招募了310名幼儿， 密切跟踪他们到成年早期，允许全面评估风险 保护因素。我们将考虑这些因素是否与以下生物标志物有关： 心血管代谢健康风险和心血管疾病临床前标志物-颈动脉内膜中层厚度 和脉搏波速度通过在家庭、学校和学校测试新的情境路径， 邻里水平这项调查将有助于确定可以有针对性的背景， 旨在减少成人健康方面的社会经济差距的方案和政策。

Project Summary/Abstract Cardiovascular disease (CVD) and diabetes are leading causes of death among adults in the US, with incident disease following years of accumulating risk conferred through various metabolic pathways (obesity, dyslipidemia, insulin resistance), immune factors (e.g., systemic inflammation), and rising blood pressure. The pathogenesis of CVD and cardiometabolic health begins in childhood, thus it is imperative to identify factors that contribute to emerging cardiometabolic health disparities. Like other chronic diseases, CVD and diabetes track a socioeconomic gradient, with greater lifelong health risk among individuals born into disadvantaged circumstances. However, no prospective studies have carefully characterized links between early socioeconomic disadvantage and adult health, addressing whether poverty during particular developmental stages is especially harmful and delineating developmentally salient risk factors that may link economic disadvantage to cardiometabolic disease (CMD) risk. Guided by the family stress framework, we propose that family-, school- and community-level factors during critical phases of development are pathways through which socioeconomic disadvantage in childhood shapes cardiometabolic health. We also consider the role of child- based protective factors that might buffer the effects of poverty on adult health outcomes. Finally, we explore how race and SES intersect to shape risk for CMD in adulthood and whether adult health behaviors are pathways through which economic disadvantage gives rise to greater propensity for CMD. The project will assess the cardiovascular health of a diverse sample of 248 adult men (aged 31-33 years) who participated in the Pittsburgh Mother & Child Project (PMCP). The parent project recruited a sample of 310 toddlers from low income families and has followed them closely to early adulthood, permitting a comprehensive assessment of risk and protective factors. We will consider whether these factors relate to biomarkers of cardiometabolic health risk and preclinical markers of CVD – carotid intima media thickness and pulse wave velocity. By testing novel contextual pathways at the family, school, and neighborhood levels this investigation will help to identify contexts that can be targeted by programs and policies aimed at reducing socioeconomic disparities in adult health.