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哈瓦那家庭医学服务区域内青少年动脉粥样硬化形成的早期迹象

Early Signs of Atherogenesis in Adolescents in a Havana Family Medicine Catchment Area.

作者信息

Valdés Wendy, Díaz-Perera Georgia, Espinosa Tania M

机构信息

14 de Junio Polyclinic, Havana, Cuba.

出版信息

MEDICC Rev. 2015 Oct;17(4):38-43. doi: 10.37757/MR2015.V17.N4.8.

Abstract

INTRODUCTION Atherosclerosis is the common underlying cause of cardiovascular diseases; the leading cause of morbidity and mortality globally. It is a major contributor to disability and poorer quality of life and is costly to health systems, individuals, families and society. Early signs of atherogenesis are manifestations of atherosclerosis and known atherogenic risk factors occurring at young ages and detectable by health professionals. Early detection of such signs in children and adolescents enables actions to prevent short- and long-term complications. OBJECTIVE Detect early signs of atherogenesis in adolescents in Family Doctor-and-Nurse Office No. 13 of the Raúl Gómez García Polyclinic in Havana's 10 de Octubre Municipality. METHODS An observational, cross-sectional descriptive study was conducted: the universe consisted of 110 adolescents and, once exclusion criteria were applied, the sample was made up of 96 adolescents in the office's geographical catchment area. Variables included sociodemographic data; measurements from physical and anthropometric examinations (weight, height, body mass index, waist circumference, blood pressure, presence of acanthosis nigricans); maternal history of diabetes mellitus and hypertension, smoking during pregnancy; birth weight and duration of exclusive breastfeeding; lifestyle (physical activity, dietary habits by frequency of consumption of fruits and vegetables, salt intake, and smoking); and a history of atherogenic risk factors and atherosclerotic diseases (hypertension, diabetes mellitus, heart disease, cerebrovascular disease, peripheral arterial disease and chronic kidney disease) in adolescents and their families. The number of early signs of atherogenesis was determined. Descriptive statistics and a chi-square test, with significance threshold set at p = 0.05, were used to examine differences by sex and age. RESULTS A total of 62.5% of participating adolescents were female and the same percent of the total were in early adolescence. Prevalent risk factors were poor dietary habits (81.3%), passive smoking (54.2%) and sedentary lifestyle (45.8%). The latter was more frequent among female and adolescents aged 10-14 years. Prehypertension and active smoking were prevalent during late adolescence. Hypertension was the disease most often found in family history (91.7%). All adolescents had at least one early sign of atherogenesis, and 72.9% had ≥3 signs, noted especially in female participants. CONCLUSIONS The high prevalence of ≥3 early signs of atherogenesis in this study suggests the need to initiate primary prevention before onset of adolescence, and even prior to birth, using a gender perspective, to conduct educational interventions designed to change the risk factors highlighted in the study and reduce cardiovascular risk in adolescents. KEYWORDS Adolescents, adolescent health, atherosclerosis, atherogenesis, arterial occlusive diseases, early detection of disease, risk factors, Cuba.

摘要

引言

动脉粥样硬化是心血管疾病的常见潜在病因,是全球发病和死亡的主要原因。它是导致残疾和生活质量下降的主要因素,对卫生系统、个人、家庭和社会造成高昂成本。动脉粥样硬化形成的早期迹象是动脉粥样硬化的表现以及在年轻时出现的已知动脉粥样硬化危险因素,并且可被卫生专业人员检测到。在儿童和青少年中早期发现这些迹象有助于采取行动预防短期和长期并发症。

目的

在哈瓦那十月十日市劳尔·戈麦斯·加西亚综合诊所第13号家庭医生和护士办公室检测青少年动脉粥样硬化形成的早期迹象。

方法

进行了一项观察性横断面描述性研究

总体包括110名青少年,应用排除标准后,样本由该办公室地理覆盖区域内的96名青少年组成。变量包括社会人口统计学数据;体格检查和人体测量学测量结果(体重、身高、体重指数、腰围、血压、黑棘皮症情况);母亲的糖尿病和高血压病史、孕期吸烟情况;出生体重和纯母乳喂养持续时间;生活方式(身体活动、根据水果和蔬菜消费频率的饮食习惯、盐摄入量和吸烟情况);以及青少年及其家庭的动脉粥样硬化危险因素和动脉粥样硬化疾病病史(高血压、糖尿病、心脏病、脑血管疾病、外周动脉疾病和慢性肾脏病)。确定动脉粥样硬化形成的早期迹象数量。使用描述性统计和卡方检验(显著性阈值设定为p = 0.05)来检验性别和年龄差异。

结果

共有62.5%的参与青少年为女性,且占总数相同比例的青少年处于青春期早期。普遍存在的危险因素是不良饮食习惯(81.3%)、被动吸烟(54.2%)和久坐不动的生活方式(45.8%)。后者在女性和10 - 14岁青少年中更为常见。青春期后期普遍存在高血压前期和主动吸烟情况。高血压是家族病史中最常出现的疾病(91.7%)。所有青少年至少有一个动脉粥样硬化形成的早期迹象,72.9%的青少年有≥3个迹象,在女性参与者中尤为明显。

结论

本研究中≥3个动脉粥样硬化形成早期迹象的高患病率表明,有必要在青春期开始之前,甚至在出生之前,从性别角度开展初级预防,进行旨在改变本研究中突出的危险因素并降低青少年心血管风险的教育干预措施。

关键词

青少年、青少年健康、动脉粥样硬化、动脉粥样硬化形成、动脉闭塞性疾病、疾病早期检测、危险因素、古巴

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