Twisk J W, Boreham C, Cran G, Savage J M, Strain J, van Mechelen W
Institute for Research in Extramural Medicine, Medical Faculty, Vrije Universiteit, Amsterdam, The Netherlands.
J Cardiovasc Risk. 1999 Dec;6(6):355-62. doi: 10.1177/204748739900600601.
To determine whether clustering of biological cardiovascular disease (CVD) risk factors exists and to investigate the longitudinal relationship between lifestyle parameters (dietary intake, physical activity and smoking behaviour) and clustering of biological CVD risk factors, which was defined as belonging to one or more sex-specific 'high-risk' quartiles for the ratio between levels of total serum cholesterol and high-density lipoprotein cholesterol, diastolic blood pressure, body fatness (sum of four skinfolds) and cardiopulmonary fitness (number of laps accomplished on a 20 m shuttle-run test).
The study was part of the Northern Ireland Young Hearts Project, a 3-year observational longitudinal study concerning adolescent boys (n=229) and girls (n=230) who were initially aged 12 years. The longitudinal relationships were analysed with generalized estimating equations.
Significant clustering of biological CVD risk factors was observed both for boys and for girls, but the stability over time was rather low. Smoking was the only lifestyle parameter related to this clustering and was observed only among girls (rate ratio 1.5, P < 0.01); furthermore, none of the lifestyle parameters was significantly related to this clustering.
Because biological CVD risk factors tend to cluster, it is important to investigate these risk factors together. However, for subjects in this age group, according to our analysis, lifestyle parameters were hardly related to this clustering.
确定生物性心血管疾病(CVD)危险因素是否存在聚集现象,并研究生活方式参数(饮食摄入、身体活动和吸烟行为)与生物性CVD危险因素聚集之间的纵向关系,生物性CVD危险因素聚集定义为血清总胆固醇与高密度脂蛋白胆固醇水平之比、舒张压、体脂(四处皮褶厚度之和)和心肺适能(20米往返跑测试完成的圈数)属于一个或多个特定性别的“高危”四分位数。
该研究是北爱尔兰青少年心脏项目的一部分,这是一项针对最初年龄为12岁的青少年男孩(n = 229)和女孩(n = 230)的为期3年的观察性纵向研究。采用广义估计方程分析纵向关系。
男孩和女孩均观察到生物性CVD危险因素的显著聚集,但随时间的稳定性相当低。吸烟是与这种聚集相关的唯一生活方式参数,且仅在女孩中观察到(率比1.5,P < 0.01);此外,没有一个生活方式参数与这种聚集显著相关。
由于生物性CVD危险因素往往会聚集,因此一起研究这些危险因素很重要。然而,根据我们的分析,对于这个年龄组的受试者,生活方式参数与这种聚集几乎没有关系。