成人高血压的身体、行为和遗传预测因素：考纳斯心血管风险队列研究的结果
Physical, behavioural and genetic predictors of adult hypertension: the findings of the Kaunas Cardiovascular Risk Cohort study.
作者信息
Petkeviciene Janina, Klumbiene Jurate, Simonyte Sandrita, Ceponiene Indre, Jureniene Kristina, Kriaucioniene Vilma, Raskiliene Asta, Smalinskiene Alina, Lesauskaite Vaiva
机构信息
Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Institute of Microbiology and Virology, Veterinary Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
出版信息
PLoS One. 2014 Oct 14;9(10):e109974. doi: 10.1371/journal.pone.0109974. eCollection 2014.
BACKGROUND
The roots of adult hypertension go back to childhood. This study aimed to examine the independent effects of physical, behavioural and genetic factors identified in childhood and mid-adulthood for prediction of adult hypertension.
METHODS
The study subjects were participants of the Kaunas Cardiovascular Risk Cohort study started in 1977 (n = 1082, age 12-13 years). In 2012, a total of 507 individuals (63.9% of eligible sample) participated in the 35-year follow-up survey. Health examination involved measurements of blood pressure (BP), anthropometric parameters, and interview about health behaviours. Subjects were genotyped for AGT (M235T), ACE (I/D, rs4340), ADM (rs7129220), and CACNB2 (rs12258967) genes polymorphisms. A genetic risk score was calculated as the sum of the number of risk alleles at each of four single nucleotide polymorphisms.
RESULTS
AGT TT genotype male carriers had the highest mean values of systolic BP in childhood. In females, ADM genotype AA was associated with the highest values of systolic and diastolic BP, while CACNB2 genotype CC carriers had the highest values of diastolic BP in childhood. Systolic and diastolic BP in childhood, gain in BMI from childhood to adulthood, and risky alcohol consumption predicted hypertension in middle-aged men. In women, genetic risk score together with diastolic BP in childhood and gain in BMI were significant predictors of adult hypertension. The comparison of four nested logistic regression models showed that the prediction of hypertension improved significantly after the addition of BMI gain. Genetic risk score had a relatively weak effect on the improvement of the model performance in women.
CONCLUSIONS
BP in childhood and the gain in BMI from childhood to adulthood were significant predictors of adult hypertension in both genders. Genetic risk score in women and risky alcohol consumption in men were independently related with the risk of adult hypertension.
背景
成人高血压的根源可追溯到儿童时期。本研究旨在探讨儿童期和成年中期所确定的身体、行为和遗传因素对预测成人高血压的独立影响。
方法
研究对象为1977年启动的考纳斯心血管风险队列研究的参与者（n = 1082，年龄12 - 13岁）。2012年，共有507人（占符合条件样本的63.9%）参与了35年的随访调查。健康检查包括测量血压（BP）、人体测量参数以及关于健康行为的访谈。对受试者进行AGT（M235T）、ACE（I/D，rs4340）、ADM（rs7129220）和CACNB2（rs12258967）基因多态性的基因分型。计算遗传风险评分，即四个单核苷酸多态性中每个位点风险等位基因数量的总和。
结果
AGT TT基因型男性携带者在儿童期收缩压均值最高。在女性中，ADM基因型AA与收缩压和舒张压的最高值相关，而CACNB2基因型CC携带者在儿童期舒张压最高。儿童期收缩压和舒张压、从儿童期到成年期BMI的增加以及危险饮酒可预测中年男性患高血压。在女性中，遗传风险评分与儿童期舒张压以及BMI的增加是成人高血压的显著预测因素。四个嵌套逻辑回归模型的比较表明，加入BMI增加后，高血压的预测显著改善。遗传风险评分对女性模型性能的改善作用相对较弱。
结论
儿童期血压以及从儿童期到成年期BMI的增加是男女成人高血压的重要预测因素。女性的遗传风险评分和男性的危险饮酒与成人高血压风险独立相关。
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