Rady Children's Hospital San Diego, San Diego, California.
Rady Children's Hospital San Diego, UC San Diego, La Jolla, California.
Haemophilia. 2018 Sep;24(5):747-754. doi: 10.1111/hae.13585. Epub 2018 Jul 13.
The origins of cardiovascular disease (CVD) begin in childhood. The primary objective of this cross-sectional cohort study was to determine the prevalence of cardiovascular risk factors in patients with congenital haemophilia A or B followed at Rady Children's Hospital San Diego Hemophilia and Thrombosis Treatment Center (HTC). We hypothesized that cardiovascular risk factors could be identified as part of a comprehensive clinic visit.
Standardized measurement of weight, height, waist circumference and blood pressure plus non-fasting glucose and lipid panel were performed. Participants and/or caregivers completed questionnaires about family history, medical history and lifestyle. Clinical data were abstracted from the medical record. Descriptive statistics, Student's t test, correlation, Mann-Whitney U test and chi-square test were performed to analyse the data.
Forty-three males (mean 12 years, range 5-20 years) enrolled. High rates of overweight and obesity, (pre)hypertension and abnormal lipids were identified. Subjects with normal weight had more days of >60 minutes of physical activity compared with those with overweight or obesity (5.2 ± 2.4 vs. 3.8 ± 2.5 day; P = 0.07). Higher weight was correlated with higher factor consumption (cor = 0.88; P < 0.001). There was no difference in target joints based on weight category (30% in normal weight vs. 25% in overweight or obese, χ = 0.11, P = 0.74), which may be attributed to high rates of prophylaxis.
Modifiable risk factors for CVD were identified as part of the study during comprehensive clinic visits. The HTC team may develop behavioural interventions to target cardiovascular risk reduction as part of the comprehensive care model.
心血管疾病（CVD）起源于儿童期。本横断面队列研究的主要目的是确定在圣地亚哥 Rady 儿童医院血友病和血栓治疗中心（HTC）接受治疗的先天性 A 型或 B 型血友病患者的心血管危险因素的流行率。我们假设可以通过综合诊所就诊来确定心血管危险因素。
对体重、身高、腰围和血压进行标准化测量，同时进行非空腹血糖和血脂检查。参与者和/或照顾者完成有关家族史、病史和生活方式的问卷调查。从病历中提取临床数据。使用描述性统计、学生 t 检验、相关性、Mann-Whitney U 检验和卡方检验来分析数据。
共有 43 名男性（平均年龄 12 岁，范围 5-20 岁）入组。超重和肥胖、（前）高血压和血脂异常的发生率较高。与超重或肥胖者相比，体重正常者的体力活动天数更多（5.2 ± 2.4 天 vs. 3.8 ± 2.5 天；P = 0.07）。体重越高，因子消耗越高（相关系数= 0.88；P < 0.001）。根据体重类别，目标关节无差异（正常体重组为 30%，超重或肥胖组为 25%，χ= 0.11，P = 0.74），这可能归因于高比例的预防治疗。
在综合诊所就诊期间，通过研究确定了 CVD 的可改变危险因素。HTC 团队可能会制定行为干预措施，作为综合护理模式的一部分，以降低心血管风险。
