Epure Adina Mihaela, Leyvraz Magali, Mivelaz Yvan, Di Bernardo Stefano, da Costa Bruno R, Chiolero Arnaud, Sekarski Nicole
Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Paediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
BMJ Open. 2018 Jun 4;8(6):e019644. doi: 10.1136/bmjopen-2017-019644.
Carotid intima-media thickness (CIMT) is a surrogate marker of atherosclerosis that is measured in adults and children to better understand the natural history of cardiovascular disease (CVD). In adults, CIMT is predictive of myocardial infarction and stroke. In children and adolescents, CIMT is used to assess vascular changes in the presence of CVD risk factors (obesity, hypertension, smoking, etc) or clinical conditions associated with a high risk for premature CVD. However, there is no comprehensive overview, in a life-course epidemiology perspective, of the risk factors and determinants of CIMT in children. It is also important to evaluate between-study differences in CIMT measurement methods and take them into consideration when drawing conclusions. Our objective is to systematically review the evidence on the relationship between CIMT and prenatal and postnatal exposures or interventions in children, as well as documenting and discussing the CIMT measurement methods.
Systematic searches of the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica (EMBASE)and Central Register of Controlled Trials (CENTRAL) databases will be conducted. The reference lists and other literatures sources will be browsed. Observational and experimental studies in children from birth up to 18 years will be included. Prenatal and postnatal exposures or interventions assessed in relationship with CIMT will be considered for inclusion. Examples might include gestational age, obesity, hypertension, tobacco exposure, specific at-risk conditions (chronic kidney disease, diabetes, etc) or statin treatment. The outcome will be CIMT assessed by ultrasonography. The setting, scanning and measurement methods for each included study will be described in detail. Results will be synthesised descriptively and, if appropriate, will be pooled across studies to perform meta-analyses. Separate meta-analyses for each exposure or intervention type will be conducted.
This systematic review will be published in a peer-reviewed journal. A report will be prepared for clinicians and other healthcare decision-makers.
CRD42017075169.
颈动脉内膜中层厚度（CIMT）是动脉粥样硬化的替代标志物，可在成人和儿童中进行测量，以更好地了解心血管疾病（CVD）的自然病史。在成人中，CIMT可预测心肌梗死和中风。在儿童和青少年中，CIMT用于评估存在CVD危险因素（肥胖、高血压、吸烟等）或与过早发生CVD高风险相关的临床状况时的血管变化。然而，从生命历程流行病学的角度来看，尚无关于儿童CIMT危险因素和决定因素的全面概述。评估CIMT测量方法之间的研究差异并在得出结论时加以考虑也很重要。我们的目标是系统地回顾关于CIMT与儿童产前和产后暴露或干预之间关系的证据，并记录和讨论CIMT测量方法。
将对医学文献分析与检索系统在线数据库（MEDLINE）、医学文摘数据库（EMBASE）和对照试验中央注册库（CENTRAL）进行系统检索。将浏览参考文献列表和其他文献来源。将纳入从出生到18岁儿童的观察性和实验性研究。将考虑纳入与CIMT相关评估的产前和产后暴露或干预。示例可能包括胎龄、肥胖、高血压、烟草暴露、特定高危状况（慢性肾病、糖尿病等）或他汀类药物治疗。结局将是通过超声检查评估的CIMT。将详细描述每项纳入研究的设置、扫描和测量方法。结果将进行描述性综合，如果合适，将在各研究中进行汇总以进行荟萃分析。将针对每种暴露或干预类型进行单独的荟萃分析。
本系统评价将发表在同行评审期刊上。将为临床医生和其他医疗保健决策者编写一份报告。
PROSPERO注册号：CRD42017075169。
