Novel cardiovascular risk markers: early outcomes and determinants in the National Survey of Health and Development

心脏和循环系统疾病（统称为心血管疾病）仍然是中年和晚年健康不良和死亡的重要原因。预防这些疾病仍然是重要的公共卫生优先事项。虽然有几个风险因素是众所周知的，但新的生物学途径也与心血管疾病风险的发展有关。这些途径涉及心肌和血管衬里，炎症过程，脂肪细胞，肾脏，肝脏和胰腺的功能，循环脂质和营养因子（特别是维生素D）。这些因素的作用需要进一步研究。独特的1946年英国出生队列（一项对2000多名从出生到60-64岁的人进行详细跟踪的研究）提供了一个重要的机会，为这些因素的作用提供了新的见解。使用这个研究框架，将有可能检查这些新的通路标记物对中年心脏和动脉的结构和功能的影响。这项研究还将提供一个重要的机会，以确定对这些新的途径标记物影响最大的因素。这些影响很可能在怀孕和中年之间的不同生命阶段起作用，反映了至少有一些导致心血管疾病风险的因素在成年之前起作用的事实。这项研究将有助于确定这些新的生物学途径是否介导了生命中不同阶段对心血管疾病起作用的因素的影响（例如生命早期的营养）以及与心血管风险密切相关的社会经济因素的影响。该研究提供的信息将提高我们对心血管风险如何在生命中发展的理解，并将有助于告诉我们如何在生命过程的不同阶段最好地预防心血管疾病。

Diseases of the heart and circulation (together referred to as cardiovascular disease) remain important causes of ill-health and death both in middle-age and in later life. Prevention of these conditions remains an important public health priority. Although several risk factors are well known, novel biological pathways have also been implicated in the development of cardiovascular disease risk. These pathways involve the heart muscle and blood vessel linings, inflammatory processes, fat cells, the function of the kidneys, liver, and pancreas, circulating lipids and nutritional factors (particularly vitamin D). The role of these factors needs to be studied further. The unique 1946 British Birth Cohort (a study of more than 2000 individuals followed in detail from birth to 60-64 years) provides an important opportunity to provide novel insights into the role of these factors. Using this study framework it will be possible to examine the influence of these novel pathway markers on the structure and function of the heart and arteries in middle-age. The investigation will also provide an important opportunity to identify the factors which have the biggest influence on these novel pathway markers. These influences may well operate at different stages of life between conception and middle age, reflecting the fact that at least some of the factors responsible for cardiovascular disease risk operate before adult life. The study will help to determine whether these novel biological pathways mediate the effects of factors operating on cardiovascular disease at different stages during life (for example nutrition in early life) and the effects of socioeconomic factors, which are strongly related to cardiovascular risk. The information provided by the study will improve our understanding of how cardiovascular risk develops through life, and will help to tell us how best to prevent cardiovascular disease at different stages of the life course.