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儿童期对成年期心血管疾病的预测。系统评价和荟萃分析。

Childhood predictors of cardiovascular disease in adulthood. A systematic review and meta-analysis.

机构信息

Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK.

Department Diabetes, King's College Hospital NHS Foundation Trust, London, UK.

出版信息

Obes Rev. 2017 Sep;18(9):1061-1070. doi: 10.1111/obr.12561. Epub 2017 May 25.

Abstract

Childhood obesity predicts the risk of adult adiposity, which is associated with the earlier onset of cardiovascular disease [adult atherosclerotic cardiovascular disease, ACVD: hypertension, increased carotid intima media thickness (CIMT) stroke, ischemic heart disease (IHD)] and dysglycaemia. Because it is not known whether childhood obesity contributes to these diseases, we conducted a systematic review of studies that examine the ability of measures of obesity in childhood to predict dysglycaemia and ACVD. Data sources were Web of Science, MEDLINE, PubMed, CINAHL, Cochrane, SCOPUS, ProQuest and reference lists. Studies measuring body mass index (BMI), skin fold thickness and waist circumference were selected; of 1,954 studies, 18 met study criteria. Childhood BMI predicted CIMT: odds ratio (OR), 3.39 (95% confidence interval (CI), 2.02 to 5.67, P < 0.001) and risk of impaired glucose tolerance in adulthood, but its ability to predict ACVD events (stroke, IHD; OR, 1.04; 95% CI, 1.02 to 1.07; P < 0.001) and hypertension (OR, 1.17, 95% CI 1.06 to 1.27, P = 0.003) was weak-moderate. Body mass index was not predictive of systolic BP (r -0.57, P = 0.08) and weakly predicted diastolic BP (r 0.21, P = 0.002). Skin fold thickness in childhood weakly predicted CIMT in female adults only (r 0.09, P < 0.05). Childhood BMI predicts the risk of dysglycaemia and abnormal CIMT in adulthood, but its ability to predict hypertension and ACVD events was weak and moderate, respectively. Skin fold thickness was a weak predictor of CIMT in female adults.

摘要

儿童肥胖预测成年肥胖的风险,而成年肥胖与心血管疾病(成人动脉粥样硬化性心血管疾病,ACVD:高血压、颈动脉内膜中层厚度增加(CIMT)、中风、缺血性心脏病(IHD)和糖代谢异常)的发病年龄提前有关。由于尚不清楚儿童肥胖是否会导致这些疾病,我们对研究肥胖指标预测糖代谢异常和 ACVD 能力的研究进行了系统回顾。数据来源为 Web of Science、MEDLINE、PubMed、CINAHL、Cochrane、SCOPUS、ProQuest 和参考文献列表。选择了测量体重指数(BMI)、皮褶厚度和腰围的研究;在 1954 项研究中,有 18 项符合研究标准。儿童时期的 BMI 预测 CIMT:比值比(OR)为 3.39(95%置信区间(CI)为 2.02 至 5.67,P<0.001)和成年时糖耐量受损的风险,但预测 ACVD 事件(中风、IHD;OR,1.04;95%CI,1.02 至 1.07;P<0.001)和高血压(OR,1.17,95%CI 1.06 至 1.27,P=0.003)的能力较弱-中等。BMI 与收缩压(r-0.57,P=0.08)无相关性,与舒张压(r 0.21,P=0.002)相关性较弱。儿童时期的皮褶厚度仅能微弱预测女性成人的 CIMT(r 0.09,P<0.05)。儿童时期的 BMI 预测成年时糖代谢异常和 CIMT 异常的风险,但预测高血压和 ACVD 事件的能力较弱和中等。皮褶厚度是女性成人 CIMT 的一个较弱预测指标。

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