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

项目摘要/摘要 心血管疾病(CVD)和糖尿病是美国成年人的主要死亡原因， 在多年积累各种代谢所带来的风险后发生疾病 途径(肥胖、血脂异常、胰岛素抵抗)、免疫因素(如全身性 炎症)和血压升高。心血管疾病的发病机制与心脏代谢健康 从童年就开始了，因此必须找出促成新出现的因素 心脏新陈代谢健康差距。像其他慢性病一样，心血管疾病和糖尿病 社会经济梯度，出生的人终身健康风险更大 处境不利。然而，没有一项前瞻性研究仔细描述了 早期社会经济劣势与成人健康之间的联系，解决贫困问题 在特定的发育阶段是特别有害的，并描绘了发育 可能将经济劣势与心脏代谢性疾病(CMD)风险联系起来的显著风险因素。 在家庭压力框架的指导下，我们建议家庭、学校和社区层面 发展关键阶段的因素是社会经济发展的途径 儿童时期的不利影响心脏代谢健康。我们还考虑了儿童的作用-- 基于保护性因素，可能缓冲贫困对成人健康结果的影响。 最后，我们探讨了种族和SES如何交叉形成成年后CMD的风险，以及是否 成年人的健康行为是经济上的劣势导致更大的 患CMD的倾向。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子(31-33岁) (PMCP)。家长项目招募了310名来自低收入家庭的幼儿样本， 一直密切跟踪他们到成年早期，允许对风险进行全面评估 和保护性因素。我们会考虑这些因素是否与 心脏代谢健康风险与心血管疾病-颈动脉内膜中层厚度的临床前标志物 脉搏波速度。通过在家庭、学校和 社区级别这项调查将有助于确定可以作为目标的背景 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.