Backhouse Ellen V, McHutchison Caroline A, Cvoro Vera, Shenkin Susan D, Wardlaw Joanna M
From the Centre for Clinical Brain Sciences (E.V.B., C.A.M., V.C., J.M.W.), Centre for Cognitive Ageing and Cognitive Epidemiology (C.A.M., V.C., S.D.S., J.M.W.), and Geriatric Medicine, Department of Clinical and Surgical Sciences (S.D.S.), University of Edinburgh; and Scottish Imaging Network (V.C., S.D.S., J.M.W.), A Platform for Scientific Excellence (SINAPSE), UK.
Neurology. 2017 Mar 7;88(10):976-984. doi: 10.1212/WNL.0000000000003687. Epub 2017 Feb 10.
Cerebrovascular disease (CVD) causes subclinical brain vascular lesions detected using neuroimaging and childhood factors may increase later CVD risk.
We searched MEDLINE, PsycINFO, and EMBASE, and meta-analyzed all available evidence on childhood (premorbid) IQ, socioeconomic status (SES), education, and subclinical CVD in later life. Overall odds ratios (OR), mean difference or correlation, and 95% confidence intervals (CIs) were calculated using random effects methods.
We identified 30 relevant studies (n = 22,890). Lower childhood IQ and lower childhood SES were associated with more white matter hyperintensities (WMH) (IQ: n = 1,512, = -0.07, 95% CI -0.12 to -0.02, = 0.007; SES: n = 243, deep WMH = -0.18, periventricular WMH = -0.146). Fewer years of education were associated with several CVD markers (n = 15,439, OR = 1.17, 95% CI 1.05 to 1.31, = 0.003). No studies assessed early life factors combined.
Childhood IQ, SES, and education are associated with increased risk of CVD on neuroimaging in later life. Further studies are required to provide further evidence and thereby inform policy.
脑血管疾病（CVD）会导致使用神经影像学检测到的亚临床脑血管病变，而儿童期因素可能会增加日后患CVD的风险。
我们检索了MEDLINE、PsycINFO和EMBASE，并对所有关于儿童期（病前）智商、社会经济地位（SES）、教育以及晚年亚临床CVD的现有证据进行了荟萃分析。使用随机效应方法计算总体优势比（OR）、均值差或相关性以及95%置信区间（CI）。
我们确定了30项相关研究（n = 22,890）。儿童期智商较低和儿童期SES较低与更多的白质高信号（WMH）相关（智商：n = 1,512，β = -0.07，95% CI -0.12至-0.02，P = 0.007；SES：n = 243，深部WMH的β = -0.18，脑室周围WMH的β = -0.146）。受教育年限较少与多种CVD标志物相关（n = 15,439，OR = 1.17，95% CI 1.05至1.31，P = 0.003）。没有研究评估早期生活因素的综合影响。
儿童期智商、SES和教育与晚年神经影像学上CVD风险增加相关。需要进一步的研究来提供更多证据，从而为政策提供依据。
