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青少年前儿童的高血压家族史和心血管危险因素。

Family history of hypertension and cardiovascular risk factors in prepubertal children.

机构信息

Biomedical Research Unit, Mexican Social Security Institute at Durango, Durango, Mexico.

出版信息

Am J Hypertens. 2010 Mar;23(3):299-304. doi: 10.1038/ajh.2009.257. Epub 2010 Jan 14.

Abstract

BACKGROUND

To determine the relationship between family history of hypertension (FHH) and cardiovascular risk factors (CVRF) in healthy prepubertal children.

DESIGN

Cross-sectional, population-based study.

SETTING

Elementary schools from San Luis Potosi and Durango, cities in middle and northern Mexico.

PARTICIPANTS

A total of 358 randomly enrolled, healthy boys and girls aged 6-10 years in Tanner stage 1, with and without FHH.

OUTCOME MEASURES

Odds ratio (OR) that estimates the relationship between FHH and CVRF.

RESULTS

FHH was identified in 72 (20.1%) children; 212 (59.2%) children had at least one CVRF, where low high-density lipoprotein (HDL)-cholesterol (36.3%), elevated waist circumference (WC) (29.3%), and hypertriglyceridemia (28.8%) were the most frequent; high-blood pressure (HBP) and hyperglycemia were recognized in 10 (3.3%) and 1 (0.3%) children. Metabolic syndrome and hyperinsulinemia were identified in 36 (10.0%) and 48 (13.4%) children. In all subjects, hyperinsulinemia (OR 2.0; 95% confidence interval (CI) 1.2-8.4), but not other CVRF was significantly associated with FHH. Subsequent analysis stratified by WC showed that FHH was not associated with CVRF in children with elevated WC. Among children with nonelevated WC, FHH in the maternal branch, but not in the paternal branch, was associated with hyperinsulinemia (OR 1.5; 95% CI 1.1-5.5), HBP (OR 4.0; 95% CI 1.3-30.1), hypertriglyceridemia (OR 1.6; 95% CI 1.1-7.2), and low HDL-cholesterol (OR 1.3; 95% CI 1.1-3.0).

CONCLUSION

Results show that FHH in the maternal branch is associated with CVRF in children with nonelevated WC.

摘要

背景

为了确定有高血压家族史(FHH)的健康青春期前儿童与心血管危险因素(CVRF)之间的关系。

设计

横断面、基于人群的研究。

地点

来自墨西哥中北部城市圣路易斯波托西和杜兰戈的小学。

参与者

共纳入 358 名随机入组的、年龄在 6-10 岁、处于 Tanner 1 期、有或无 FHH 的健康男孩和女孩。

结局指标

比值比(OR)用于估计 FHH 与 CVRF 之间的关系。

结果

72 名(20.1%)儿童存在 FHH;212 名(59.2%)儿童存在至少 1 种 CVRF,其中最常见的是低高密度脂蛋白(HDL)-胆固醇(36.3%)、升高的腰围(WC)(29.3%)和高三酰甘油血症(28.8%);10 名(3.3%)和 1 名(0.3%)儿童患有高血压和高血糖。36 名(10.0%)和 48 名(13.4%)儿童存在代谢综合征和高胰岛素血症。在所有受试者中,高胰岛素血症(OR 2.0;95%置信区间(CI)1.2-8.4),而其他 CVRF 与 FHH 无显著相关性。按 WC 分层的后续分析显示,FHH 与 WC 升高的儿童的 CVRF 无相关性。在 WC 无升高的儿童中,FHH 与母亲一方而非父亲一方相关,与高胰岛素血症(OR 1.5;95% CI 1.1-5.5)、高血压(OR 4.0;95% CI 1.3-30.1)、高三酰甘油血症(OR 1.6;95% CI 1.1-7.2)和低 HDL-胆固醇(OR 1.3;95% CI 1.1-3.0)相关。

结论

结果表明,WC 无升高的儿童中,母亲一方的 FHH 与 CVRF 相关。

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