Hart C L, Taylor M D, Smith G Davey, Whalley L J, Starr J M, Hole D J, Wilson V, Deary I J
Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK.
Soc Sci Med. 2004 Nov;59(10):2131-8. doi: 10.1016/j.socscimed.2004.03.016.
This study investigated the influence of childhood IQ on the relationships between risk factors and cardiovascular disease (CVD), coronary heart disease (CHD) and stroke in adulthood. Participants were from the Midspan prospective cohort studies which were conducted on adults in Scotland in the 1970s. Data on risk factors were collected from a questionnaire and at a screening examination, and participants were followed up for 25 years for hospital admissions and mortality. 938 Midspan participants were successfully matched with their age 11 IQ from the Scottish Mental Survey 1932, in which 1921-born children attending schools in Scotland took a cognitive ability test. Childhood IQ was negatively correlated with diastolic and systolic blood pressure, and positively correlated with height and respiratory function in adulthood. For each of CVD, CHD and stroke, defined as either a hospital admission or death, there was an increased relative rate per standard deviation decrease (15 points) in childhood IQ of 1.11 (95% confidence interval 1.01-1.23), 1.16 (1.03-1.32) and 1.10 (0.88-1.36), respectively. With events divided into those first occurring before and those first occurring after the age of 65, the relationships between childhood IQ and CVD, CHD and stroke were only seen before age 65 and not after age 65. Blood pressure, height, respiratory function and smoking were associated with CVD events. Relationships were stronger in the early compared to the later period for smoking and FEV1, and stronger in the later compared to the earlier period for blood pressure. Adjustment for childhood IQ had small attenuating effects on the risk factor-CVD relationship before age 65 and no effects after age 65. Adjustment for risk factors attenuated the childhood IQ-CVD relationship by a small amount before age 65. Childhood IQ was associated with CVD risk factors and events and can be considered an important new risk factor.
本研究调查了儿童期智商对成年期风险因素与心血管疾病(CVD)、冠心病(CHD)和中风之间关系的影响。参与者来自20世纪70年代在苏格兰对成年人进行的Midspan前瞻性队列研究。风险因素的数据通过问卷调查和筛查检查收集,参与者被随访25年以获取住院情况和死亡率信息。938名Midspan参与者成功与他们1932年苏格兰精神调查中11岁时的智商进行了匹配,在该调查中,1921年出生在苏格兰上学的儿童参加了认知能力测试。儿童期智商与成年期舒张压和收缩压呈负相关,与身高和呼吸功能呈正相关。对于定义为住院或死亡的CVD、CHD和中风中的每一种,儿童期智商每降低一个标准差(15分),相对发生率分别增加1.11(95%置信区间1.01 - 1.23)、1.16(1.03 - 1.32)和1.10(0.88 - 1.36)。将事件分为65岁之前首次发生的和65岁之后首次发生的,儿童期智商与CVD、CHD和中风之间的关系仅在65岁之前可见,65岁之后则不可见。血压、身高、呼吸功能和吸烟与CVD事件相关。吸烟和第一秒用力呼气量(FEV1)的关系在早期比后期更强,血压的关系在后期比早期更强。对儿童期智商进行调整对65岁之前风险因素与CVD的关系有较小的减弱作用,对65岁之后则无影响。对风险因素进行调整在65岁之前使儿童期智商与CVD的关系略有减弱。儿童期智商与CVD风险因素及事件相关,可被视为一个重要的新风险因素。