Karolinska Institutet, Stockholm, Sweden.
Eur J Public Health. 2012 Dec;22(6):840-7. doi: 10.1093/eurpub/ckr180. Epub 2011 Dec 13.
Precursors of cardiovascular diseases (CVD) originate in childhood. We investigated relationships of children's CVD risk factors with parent's socio-economic position (SEP) and lifestyle and how CVD risk factors correlate within families.
We studied 602 families with 2141 individuals comprising two full sibs; aged 5-14 years, and their biological parents (Uppsala Family Study). Parental SEP (occupational class and education) and lifestyle habits [smoking, physical activity (PA), alcohol consumption] were taken from questionnaires. Associations with cholesterol, ApoB/ApoA1, leptin, adiponectin, blood pressure, body mass index (BMI) and overweight/obesity (OW/OB) were analysed by linear/logistic regression. Results were adjusted for child's age, gender, pubertal stage and family clustering.
We observed no consistent associations between parental SEP and children's CVD risk factors. Parental lifestyle had stronger effects, independent of parental SEP. Children of smoking fathers had higher BMI (4%, 95% CI 1-7%) and leptin levels (27%, 95% CI 1.00-61.60%). Children of mothers reporting vigorous PA had lower BMI, cholesterol and decreased odds for OW/OB with a possible dose effect. Compared with mothers reporting no vigorous activity, mothers with ≤75 min and 76-150 min/week of vigorous activity had 43% (OR 0.57, 95% CI 0.22-0.89) and 72% (OR 0.28, 95% CI 0.14-0.60) lower risk of having an OW/OB child, respectively, after adjustment for confounders. Independent, consistently stronger and significant associations were found between all studied parents' and children's CVD risk factors.
Parental behaviours: smoking, alcohol consumption, low PA are associated with higher levels of CVD risk factors (BMI, OW/OB, cholesterol) in children. Strong correlations in CVD risk factors within families not related to parental SEP/lifestyle suggest a role of genetics in influencing children's CVD risk factors. Public health policies should target families with unhealthy lifestyles.
心血管疾病(CVD)的发生可追溯到儿童时期。我们研究了儿童 CVD 风险因素与父母社会经济地位(SEP)和生活方式的关系,以及 CVD 风险因素在家庭内的相关性。
我们研究了由 602 个家庭的 2141 名个体组成的队列,这些个体包括两个全同胞,年龄在 5-14 岁之间,以及他们的亲生父母(乌普萨拉家庭研究)。父母的 SEP(职业类别和教育程度)和生活方式习惯(吸烟、体力活动、饮酒)均来自问卷调查。采用线性/逻辑回归分析胆固醇、载脂蛋白 B/载脂蛋白 A1、瘦素、脂联素、血压、体重指数(BMI)和超重/肥胖(OW/OB)与这些因素的关联。结果根据儿童年龄、性别、青春期阶段和家庭聚集进行了调整。
我们没有观察到父母 SEP 与儿童 CVD 风险因素之间存在一致的关联。父母的生活方式对儿童 CVD 风险因素的影响更强,且独立于父母 SEP。父亲吸烟的儿童 BMI 更高(4%,95%CI 1-7%),瘦素水平更高(27%,95%CI 1.00-61.60%)。母亲报告剧烈体力活动的儿童 BMI、胆固醇水平更低,且超重/肥胖的几率降低,可能存在剂量效应。与不报告剧烈活动的母亲相比,每周报告运动量≤75 分钟和 76-150 分钟的母亲,其子女超重/肥胖的风险分别降低 43%(OR 0.57,95% CI 0.22-0.89)和 72%(OR 0.28,95% CI 0.14-0.60),在调整了混杂因素后。所有研究父母与儿童 CVD 风险因素之间存在独立、一致且显著的关联。
父母的行为:吸烟、饮酒、低体力活动与儿童 CVD 风险因素(BMI、OW/OB、胆固醇)水平升高相关。家庭内 CVD 风险因素之间存在强烈相关性,与父母 SEP/生活方式无关,提示遗传因素在影响儿童 CVD 风险因素方面可能发挥作用。公共卫生政策应针对生活方式不健康的家庭。