Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, and Turku PET Center, Turku University Hospital, Turku, Finland.
J Am Coll Cardiol. 2012 Oct 9;60(15):1364-70. doi: 10.1016/j.jacc.2012.05.045. Epub 2012 Sep 12.
The purpose of this study was to examine the roles of adolescence risk factors in predicting coronary artery calcium (CAC).
Elevated coronary heart disease risk factor levels in adolescence may predict subsequent CAC independently of change in risk factor levels from adolescence to adulthood.
CAC was assessed in 589 subjects 40 to 46 years of age from the Cardiovascular Risk in Young Finns Study. Risk factor levels were measured in 1980 (12 to 18 years) and in 2007.
The prevalence of any CAC was 19.2% (27.9% in men and 12.2% in women). Age, levels of systolic blood pressure (BP), total cholesterol, and low-density lipoprotein cholesterol (LDL-C) in adolescence, as well as systolic BP, total cholesterol, diastolic BP, and pack-years of smoking in adulthood were higher among subjects with CAC than those without CAC. Adolescence LDL-C and systolic BP levels predicted CAC in adulthood independently of 27-year changes in these risk factors. The multivariable odds ratios were 1.34 (95% confidence interval: 1.05 to 1.70; p=0.02) and 1.38 (95% confidence interval: 1.08 to 1.77; p=0.01), for 1-SD increase in adolescence LDL-C and systolic BP, respectively. Exposure to both of these risk factors in adolescence (defined as values at or above the age- and sex-specific 75th percentile) substantially increased the risk of CAC (multivariable odds ratio: 3.5 [95% confidence interval: 1.7 to 7.2; p=0.007]) between groups with no versus both risk factors.
Elevated adolescence LDL-C and systolic BP levels are independent predictors of adulthood CAC, indicating that adolescence risk factor levels play an important role in the pathogenesis of coronary heart disease.
本研究旨在探讨青春期危险因素在预测冠状动脉钙（CAC）中的作用。
青春期升高的冠心病危险因素水平可能独立于青春期至成年期的危险因素水平变化预测随后的 CAC。
对心血管风险在年轻芬兰人中的研究的 589 名 40 至 46 岁的受试者进行 CAC 评估。1980 年（12 至 18 岁）和 2007 年测量了危险因素水平。
任何 CAC 的患病率为 19.2%（男性为 27.9%，女性为 12.2%）。CAC 受试者的年龄、青春期的收缩压（BP）、总胆固醇和低密度脂蛋白胆固醇（LDL-C）水平以及成年期的收缩压、总胆固醇、舒张压和吸烟包年数均高于无 CAC 受试者。青春期 LDL-C 和收缩压水平可独立预测成年期 CAC，而这些危险因素在 27 年内的变化并无预测作用。多变量比值比分别为 1.34（95%置信区间：1.05 至 1.70；p=0.02）和 1.38（95%置信区间：1.08 至 1.77；p=0.01），代表青春期 LDL-C 和收缩压各增加 1 个标准差。青春期暴露于这两种危险因素（定义为达到或超过年龄和性别特异性第 75 百分位数的水平）会显著增加 CAC 的风险（多变量比值比：3.5 [95%置信区间：1.7 至 7.2；p=0.007]）。
青春期 LDL-C 和收缩压水平升高是成年 CAC 的独立预测因子，表明青春期危险因素水平在冠心病发病机制中起重要作用。
