Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC
Department of Medicine, University of Otago, Wellington, New Zealand.
J Am Heart Assoc. 2017 Oct 11;6(10):e007071. doi: 10.1161/JAHA.117.007071.
Atherosclerosis begins during preadolescence and is occurring at an accelerated rate. This acceleration has been linked to poor lifestyle behaviors and subsequent cardiometabolic complications. Although the clustering of cardiometabolic risk factors has been recognized for over 2 decades, previous studies in children have predominantly examined the relationships between atherosclerosis and individual cardiometabolic risk factors or have grouped together preadolescent and adolescent children. Further, no known studies have included glycated hemoglobin or central hemodynamic measures such as central systolic blood pressure and augmentation index.
Principal component analysis was performed on a cross-sectional sample of 392 children (aged 9.5 years, 50% girls) from 3 representative sample sites across New Zealand. Four factors explained 60% of the variance in the measured variables. In order of variance explained, the factors were: blood pressure (central systolic blood pressure and peripheral systolic and diastolic blood pressure), adiposity (waist circumference, body mass index, and glycated hemoglobin), lipids (total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol), and vascular (augmentation index, heart rate, and fasting blood glucose).
In accordance with previous findings in adults and adolescents, one common factor is unlikely to define cardiometabolic health in preadolescent children. Each of the factors, except vascular, which was predominantly explained by augmentation index, are in agreement with previous findings in adolescents. An additional novel finding was that glycated hemoglobin and fasting blood glucose loaded onto different factors, supporting previous work suggesting that fasting blood glucose indicates short-term glycemic control, whereas glycated hemoglobin reflects chronic glycemic control.
URL: www.anzctr.org.au/. ID: ACTRN12614000433606.
动脉粥样硬化始于青春期前，并呈加速发展趋势。这种加速与不良生活方式行为以及随后发生的心血管代谢并发症有关。尽管心血管代谢危险因素的聚集已被认识超过 20 年，但以前在儿童中的研究主要集中在动脉粥样硬化与单个心血管代谢危险因素之间的关系，或者将青春期前和青春期的儿童归为一组。此外，没有已知的研究包括糖化血红蛋白或中心血流动力学指标，如中心收缩压和增强指数。
对来自新西兰 3 个代表性采样点的 392 名儿童（年龄 9.5 岁，50%为女孩）的横断面样本进行主成分分析。四个因素解释了测量变量 60%的方差。按方差解释的顺序，这些因素是：血压（中心收缩压和外周收缩压及舒张压）、肥胖（腰围、体重指数和糖化血红蛋白）、血脂（总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇）和血管（增强指数、心率和空腹血糖）。
与成人和青少年的先前发现一致，不太可能有一个单一的因素可以定义青春期前儿童的心血管代谢健康。除了主要由增强指数解释的血管因素外，其他每个因素都与青少年的先前发现一致。一个新的发现是，糖化血红蛋白和空腹血糖加载到不同的因素上，这支持了以前的工作，表明空腹血糖反映短期血糖控制，而糖化血红蛋白反映慢性血糖控制。
