Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
Heart Center, Turku University Hospital, Turku, Finland.
J Am Heart Assoc. 2017 Aug 16;6(8):e005632. doi: 10.1161/JAHA.117.005632.
There is paucity of knowledge concerning the specific age in youth when the associations of metabolic syndrome (MetS) begin to be operative. Thus, we investigated the relation of age to the associations of childhood MetS with adult MetS, type 2 diabetes mellitus and high carotid intima-media thickness.
Five thousand eight-hundred three participants were analyzed in 4 cohort studies (Cardiovascular Risk in Young Finns, Bogalusa Heart Study, Princeton Lipid Research Study, Insulin Study). International cutoffs and previously used 75th percentile cutoffs were used for children to define MetS and its components. Mean follow-up period was 22.3 years. Logistic regression was used to calculate risk ratios and 95% confidence intervals. Childhood MetS and overweight were associated with over 2.4-fold risk for adult MetS from the age of 5 years onward. Risk for type 2 diabetes mellitus was increased from the age of 8 (risk ratio, 2.6-4.1; 95% confidence interval, 1.35-6.76 and 1.12-7.24, respectively) onward for the 2 childhood MetS criteria based on international cut-off values and for childhood overweight. Risk for high carotid intima-media thickness was significant at ages 11 to 18 years in relation to childhood MetS or overweight (risk ratio, 2.44-4.22; 95% confidence interval, 1.55-3.55 and 2.55-5.66, respectively). Continuous childhood MetS score was associated with adult MetS from the age of 5, with type 2 diabetes mellitus from the age of 14 and with high carotid intima-media thickness from the age of 11 years onward.
Adult MetS was predicted by MetS in childhood beginning at age 5. However, adult type 2 diabetes mellitus and subclinical atherosclerosis were not predicted by childhood data until after age 8. Body mass index measurement alone at the same age points provided similar findings.
目前对于代谢综合征（MetS）相关关联开始起作用的青年特定年龄，人们的了解甚少。因此，我们研究了年龄与儿童期代谢综合征与成人代谢综合征、2 型糖尿病和高颈动脉内膜中层厚度之间的关系。
在 4 项队列研究（芬兰年轻人心血管风险研究、博加卢萨心脏研究、普林斯顿脂质研究、胰岛素研究）中分析了 5803 名参与者。使用国际标准和之前使用的第 75 百分位标准来为儿童定义代谢综合征及其组成部分。平均随访时间为 22.3 年。使用逻辑回归计算风险比和 95%置信区间。从 5 岁开始，儿童期代谢综合征和超重与成人代谢综合征的风险比超过 2.4 倍。基于国际截断值的两种儿童期代谢综合征标准和儿童超重，从 8 岁开始，2 型糖尿病的风险增加（风险比分别为 2.6-4.1、1.35-6.76 和 1.12-7.24）。与儿童期代谢综合征或超重相关，颈动脉内膜中层厚度高的风险在 11 至 18 岁之间显著（风险比分别为 2.44-4.22、1.55-3.55 和 2.55-5.66）。从 5 岁开始，连续的儿童期代谢综合征评分与成人代谢综合征相关，从 14 岁开始与 2 型糖尿病相关，从 11 岁开始与高颈动脉内膜中层厚度相关。
从 5 岁开始，儿童期代谢综合征可预测成人代谢综合征。然而，直到 8 岁以后，成人 2 型糖尿病和亚临床动脉粥样硬化才开始被儿童数据预测。在相同的年龄点测量体重指数也会得到相似的发现。
