Dratva Julia, Caviezel Seraina, Schaffner Emmanuel, Bettschart Robert, Kuenzli Nino, Schindler Christian, Schmidt-Trucksäss Arno, Stolz Daiana, Zemp Elisabeth, Probst-Hensch Nicole
Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland.
Swiss Tropical and Public Health Institute, Basel, CH, Socinstrasse 57, CH-4002 Basel, Switzerland; University of Basel, CH, Petersplatz 1, CH-4031 Basel, Switzerland; Department for Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, St. Jakob-Arena, Brüglingen 33, CH-4052 Basel, Switzerland.
Atherosclerosis. 2015 Dec;243(2):609-15. doi: 10.1016/j.atherosclerosis.2015.10.021. Epub 2015 Oct 23.
Inflammatory risk factors in childhood, e.g. obesity, impact on carotid artery intima media thickness (CIMT), an early indicator of atherosclerosis. Little is known on potential infectious origins in childhood. We investigated the association between number of reported different childhood infectious diseases and CIMT in adolescence.
288 SAPALDIA offspring (8-21years) underwent a clinical examination in 2010-2011: anthropometry, blood pressure, CIMT, blood draw (cardiovascular biomarkers, cotinine). Offspring and parents gave information on individuals' and family health, child's vaccination status, infectious diseases and other early life factors. Life-time prevalence of bronchitis, pneumonia, tonsillitis, otitis, mononucleosis, meningitis, appendicitis, and scarlet fever were investigated, separately, and as cumulative infectious disease score. Multilevel adjusted linear regression analysis on the association between subjects' CIMT average and infectious diseases score was performed, stratifying by sex.
Youth (mean age 14.8 yrs; 53% female) reported on average 1.3 of the listed infectious diseases; 22% boys and 15% girls reported ≥3 infectious diseases (p = 0.136). Two-thirds were vaccinated according to recommendations (boys 56%, girls 61.5%, p = 0.567). Sex-stratified analyses yielded significantly increased CIMT in boys with ≥3 infectious diseases vs. none (0.046 mm, 95%CI 0.024; 0.068). In girls, the effect was of same direction but statistically non-significant (0.011 mm, 95%CI -0.015; 0.036).
The SAPALDIA Youth study complements current evidence on infectious origins of atherosclerosis in adults. The larger effects observed in boys may relate to a higher vulnerability of the vasculature and/or to infectious pathogens. Our data are suggestive of an early impact of childhood infectious diseases on vascular health.
儿童期的炎症风险因素，如肥胖，会影响颈动脉内膜中层厚度（CIMT），这是动脉粥样硬化的早期指标。关于儿童期潜在感染源的情况知之甚少。我们调查了报告的不同儿童期传染病数量与青少年CIMT之间的关联。
288名SAPALDIA研究对象的后代（8 - 21岁）在2010 - 2011年接受了临床检查：人体测量、血压、CIMT、采血（检测心血管生物标志物、可替宁）。研究对象及其父母提供了关于个人和家庭健康、儿童疫苗接种状况、传染病及其他早期生活因素的信息。分别调查了支气管炎、肺炎、扁桃体炎、中耳炎、单核细胞增多症、脑膜炎、阑尾炎和猩红热的终生患病率，并计算累积传染病评分。对研究对象的CIMT平均值与传染病评分之间的关联进行多水平校正线性回归分析，并按性别分层。
青少年（平均年龄14.8岁；53%为女性）报告的上述传染病平均为1.3种；22%的男孩和15%的女孩报告有≥3种传染病（p = 0.136）。三分之二的人按建议接种了疫苗（男孩56%，女孩61.5%，p = 0.567）。按性别分层分析显示，有≥3种传染病的男孩与无传染病的男孩相比，CIMT显著增加（0.046毫米，95%置信区间0.024；0.068）。在女孩中，效果方向相同，但无统计学意义（0.011毫米，95%置信区间 - 0.015；0.036）。
SAPALDIA青少年研究补充了目前关于成人动脉粥样硬化感染源的证据。在男孩中观察到的较大影响可能与血管系统更高的易损性和/或感染病原体有关。我们的数据表明儿童期传染病对血管健康有早期影响。
