Department of Medicine, University of Turku and Turku University Central Hospital, PO Box 52, 20500 Turku, Finland.
Eur Heart J. 2010 Jul;31(14):1745-51. doi: 10.1093/eurheartj/ehq141. Epub 2010 May 25.
The aim of this study is to evaluate whether childhood risk factors are associated with a 6-year change in carotid intima-media thickness (IMT) in young adulthood independent of the current risk factors.
The Cardiovascular Risk in Young Finns cohort consisted of 1809 subjects who were followed-up for 27 years since baseline (1980, age 3-18 years) and having carotid IMT measured both in 2001 and 2007. Cardiovascular risk factors were assessed repeatedly since childhood. A genotype risk score was calculated using 17 newly identified genetic variants associating with cardiovascular morbidity. The number of childhood risk factors (high LDL-cholesterol, low HDL-cholesterol, high blood pressure, obesity, diabetes, smoking, low physical activity, infrequent fruit consumption) was associated with a 6-year change in adulthood IMT. In subjects with 0, 1, 2, and > or =3 childhood risk factors, IMT [mean (95% CI)) increased by 35 (28-42), 46 (40-52), 49 (41-57), and 61 (49-73) microm (P = 0.0001). This association remained significant when adjusted for adulthood risk score and genotype score (P = 0.007). Of the individual childhood variables, infrequent fruit consumption ((beta (95% CI) for 1-SD change -5(-9 to -1), P = 0.03) and low physical activity (-6(-10 to -2), P = 0.01) were associated with accelerated IMT progression after taking into account these variables assessed in adulthood.
These findings indicate that children with risk factors have increased atherosclerosis progression rate in adulthood, and support the idea that the prevention of atherosclerosis by means of life style could be effective when initiated in childhood.
本研究旨在评估儿童时期的危险因素是否与年轻人颈动脉内膜中层厚度（IMT）在成年后的 6 年变化独立于当前的危险因素有关。
心血管风险在年轻的芬兰人队列包括 1809 名受试者，他们从基线开始（1980 年，年龄 3-18 岁）随访 27 年，在 2001 年和 2007 年都测量了颈动脉 IMT。自儿童时期以来，心血管危险因素被反复评估。使用 17 个新发现的与心血管发病率相关的遗传变异，计算了基因型风险评分。童年时期危险因素（高 LDL-胆固醇、低 HDL-胆固醇、高血压、肥胖、糖尿病、吸烟、低体力活动、水果摄入频率低）的数量与成年期 IMT 的 6 年变化有关。在危险因素数量为 0、1、2 和≥3 的受试者中，IMT [平均值（95%CI）]分别增加了 35（28-42）、46（40-52）、49（41-57）和 61（49-73）μm（P = 0.0001）。当调整成年风险评分和基因型评分时，这种相关性仍然显著（P = 0.007）。在个体儿童变量中，水果摄入频率低（5（-9 到-1），P = 0.03）和体力活动少（-6（-10 到-2），P = 0.01）与考虑到成年时评估的这些变量后 IMT 进展加速有关。
这些发现表明，有危险因素的儿童在成年后动脉粥样硬化进展速度加快，支持通过生活方式预防动脉粥样硬化的观点，当从儿童时期开始时可能是有效的。
