Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.
Murdoch Children's Research Institute, Parkville, Victoria, Australia.
BMJ Open. 2019 Jul 4;9(Suppl 3):23-33. doi: 10.1136/bmjopen-2017-020264.
To describe a well-established marker of cardiovascular risk, carotid intima-media thickness (IMT) and related measures (artery distensibility and elasticity) in children aged 11-12 years old and mid-life adults, and examine associations within parent-child dyads.
Cross-sectional study (Child Health CheckPoint), nested within a prospective cohort study, the Longitudinal Study of Australian Children (LSAC).
Assessment centres in seven Australian major cities and eight selected regional towns, February 2015 to March 2016.
Of all participating CheckPoint families (n=1874), 1489 children (50.0% girls) and 1476 parents (86.8% mothers) with carotid IMT data were included. Survey weights and methods were applied to account for LSAC's complex sample design and clustering within postcodes and strata.
Ultrasound of the right carotid artery was performed using standardised protocols. Primary outcomes were mean and maximum far-wall carotid IMT, quantified using semiautomated edge detection software. Secondary outcomes were carotid artery distensibility and elasticity. Pearson's correlation coefficients and multivariable linear regression models were used to assess parent-child concordance. Random effects modelling on a subset of ultrasounds (with repeated measurements) was used to assess reliability of the child carotid IMT measure.
The average mean and maximum child carotid IMT were 0.50 mm (SD 0.06) and 0.58 mm (SD 0.05), respectively. In adults, average mean and maximum carotid IMT were 0.57 mm (SD 0.07) and 0.66 mm (SD 0.10), respectively. Mother-child correlations for mean and maximum carotid IMT were 0.12 (95% CI 0.05 to 0.23) and 0.10 (95% CI 0.03 to 0.21), respectively. For carotid artery distensibility and elasticity, mother-child correlations were 0.19 (95% CI 0.10 to 0.25) and 0.11 (95% CI 0.02 to 0.18), respectively. There was no strong evidence of father-child correlation in any measure.
We provide Australian values for carotid vascular measures and report a modest mother-child concordance. Both genetic and environmental exposures are likely to contribute to carotid IMT.
描述一种成熟的心血管风险标志物——颈动脉内膜中层厚度（IMT）及其相关指标（动脉可扩张性和弹性），并评估 11-12 岁儿童和中年成年人的颈动脉 IMT 及其相关指标的水平，同时还分析了亲子间的关联。
横断面研究（儿童健康检查点），嵌套于前瞻性队列研究——澳大利亚儿童纵向研究（LSAC）。
2015 年 2 月至 2016 年 3 月，澳大利亚七个主要城市和八个选定的地区城镇的评估中心。
所有参与检查点的家庭（n=1874）中，有 1489 名儿童（50.0%为女孩）和 1476 名家长（86.8%为母亲）具有颈动脉 IMT 数据。采用调查权重和方法来考虑 LSAC 的复杂样本设计以及邮政编码和分层内的聚类。
使用标准化协议对右颈动脉进行超声检查。主要结局是使用半自动边缘检测软件量化的平均和最大远壁颈动脉 IMT。次要结局是颈动脉可扩张性和弹性。采用 Pearson 相关系数和多变量线性回归模型评估亲子一致性。对重复测量的部分超声检查使用随机效应模型来评估儿童颈动脉 IMT 测量的可靠性。
儿童平均和最大颈动脉 IMT 分别为 0.50mm（标准差 0.06）和 0.58mm（标准差 0.05）。成年人的平均和最大颈动脉 IMT 分别为 0.57mm（标准差 0.07）和 0.66mm（标准差 0.10）。母亲与孩子颈动脉 IMT 的平均和最大相关性分别为 0.12（95%置信区间 0.05 至 0.23）和 0.10（95%置信区间 0.03 至 0.21）。颈动脉可扩张性和弹性的母亲与孩子相关性分别为 0.19（95%置信区间 0.10 至 0.25）和 0.11（95%置信区间 0.02 至 0.18）。在任何指标中，均没有强有力的证据表明父亲与孩子之间存在相关性。
我们提供了澳大利亚颈动脉血管测量值，并报告了适度的母子一致性。遗传和环境暴露都可能导致颈动脉 IMT 增加。
