Ward Joseph L, Harrison Katherine, Viner Russell M, Costello Anthony, Heys Michelle
UCL Institute of Child Health, University College London, London, United Kingdom.
University College London Hospitals NHS Foundation Trust, London, United Kingdom.
PLoS One. 2018 Jan 16;13(1):e0190443. doi: 10.1371/journal.pone.0190443. eCollection 2018.
Life-course studies are needed to explore how exposures during adolescence, particularly puberty, contribute to later cardiovascular risk and cognitive health in low and middle-income countries (LMIC), where 90% of the world's young people live. The extent of any existing cohorts investigating these outcomes in LMIC has not previously been described.
We performed a systematic literature review to identify population cohort studies of adolescents in LMIC that assessed anthropometry and any of cardiovascular risk (blood pressure, physical activity, plasma glucose/lipid profile and substance misuse), puberty (age at menarche, Tanner staging, or other form of pubertal staging) or cognitive outcomes. Studies that recruited participants on the basis of a pre-existing condition or involved less than 500 young people were excluded.
1829 studies were identified, and 24 cohorts fulfilled inclusion criteria based in Asia (10), Africa (6) and South / Central America (8). 14 (58%) of cohorts identified were based in one of four countries; India, Brazil, Vietnam or Ethiopia. Only 2 cohorts included a comprehensive cardiovascular assessment, tanner pubertal staging, and cognitive outcomes.
Improved utilisation of existing datasets and additional cohort studies of adolescents in LMIC that collect contemporaneous measures of growth, cognition, cardiovascular risk and pubertal development are needed to better understand how this period of the life course influences future non-communicable disease morbidity and cognitive outcomes.
在低收入和中等收入国家（LMIC），90%的世界年轻人生活于此，需要开展生命历程研究来探索青春期（尤其是青春期发育阶段）的暴露因素如何影响后期的心血管风险和认知健康。此前尚未描述过在低收入和中等收入国家调查这些结果的现有队列研究的范围。
我们进行了一项系统的文献综述，以确定低收入和中等收入国家青少年的人群队列研究，这些研究评估了人体测量学以及任何心血管风险（血压、身体活动、血浆葡萄糖/脂质谱和物质滥用）、青春期发育（初潮年龄、坦纳分期或其他形式的青春期分期）或认知结果。基于既往疾病招募参与者或涉及少于500名年轻人的研究被排除。
共识别出1829项研究，24个队列符合纳入标准，这些队列分布在亚洲（10个）、非洲（6个）和南美洲/中美洲（8个）。所识别的队列中有14个（58%）来自四个国家之一；印度、巴西、越南或埃塞俄比亚。只有2个队列包括全面的心血管评估、坦纳青春期分期和认知结果。
需要更好地利用现有数据集，并在低收入和中等收入国家开展更多关于青少年的队列研究，收集生长、认知、心血管风险和青春期发育的同步测量数据，以更好地了解生命历程中的这一时期如何影响未来的非传染性疾病发病率和认知结果。
