Prins-van Ginkel A C, Bruijning-Verhagen P C J, Wijga A H, Bots M L, Gehring U, van der Hoek W, Koppelman G H, van Rossem L, Uiterwaal C S P M, Smit H A, van der Sande M A B
Center for Infectious Diseases, Epidemiology, and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Epidemiol Infect. 2018 Nov 8;147:e37. doi: 10.1017/S095026881800287X.
Atherosclerotic changes can be measured as changes in common carotid intima media thickness (CIMT). It is hypothesised that repeated infection-associated inflammatory responses in childhood contribute to the atherosclerotic process. We set out to determine whether the frequency of infectious diseases in childhood is associated with CIMT in adolescence. The study is part of the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) population-based birth cohort. At age 16 years, common CIMT was measured. We collected general practitioner (GP) diagnosed infections and prescribed antibiotics. Parent-reported infections were retrieved from annual questionnaires. Linear regression analysis assessed the association between number of infections during the first 4 years of life and common CIMT. Common CIMT measurement, GP and questionnaire data were available for 221 participants. No association was observed between the infection measures and CIMT. In a subgroup analysis, significant positive associations with CIMT were observed in participants with low parental education for 2-3 or ⩾7 GP diagnosed infections (+26.4 µm, 95% CI 0.4-52.4 and +26.8 µm, 95% CI 3.6-49.9, respectively) and ⩾3 antibiotic prescriptions (+35.5 µm, 95%CI 15.8-55.3). Overall, early childhood infections were not associated with common CIMT in adolescence. However, a higher number of childhood infections might contribute to the inflammatory process of atherosclerosis in subgroups with low education, this needs to be confirmed in future studies.
动脉粥样硬化变化可通过颈总动脉内膜中层厚度(CIMT)的变化来衡量。据推测,儿童时期反复出现的与感染相关的炎症反应会促进动脉粥样硬化进程。我们着手确定儿童时期传染病的发生频率是否与青少年的CIMT相关。该研究是基于人群的哮喘与螨过敏预防及发病率(PIAMA)出生队列研究的一部分。在16岁时测量颈总动脉CIMT。我们收集了全科医生(GP)诊断的感染情况和开具的抗生素处方。从年度问卷中获取家长报告的感染情况。线性回归分析评估了生命最初4年的感染次数与颈总动脉CIMT之间的关联。共有221名参与者提供了颈总动脉CIMT测量值、全科医生及问卷数据。未观察到感染指标与CIMT之间存在关联。在亚组分析中,对于父母教育程度较低的参与者,在2 - 3次或≥7次全科医生诊断的感染(分别为+26.4 µm,95%可信区间0.4 - 52.4和+26.8 µm,95%可信区间3.6 - 49.9)以及≥3次抗生素处方(+35.5 µm,95%可信区间15.8 - 55.3)的情况下,观察到与CIMT存在显著正相关。总体而言,儿童早期感染与青少年的颈总动脉CIMT无关。然而,儿童时期感染次数较多可能会在教育程度较低的亚组中促进动脉粥样硬化的炎症过程,这需要在未来的研究中得到证实。