Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Exp Gerontol. 2020 Jul 15;136:110947. doi: 10.1016/j.exger.2020.110947. Epub 2020 Apr 12.
Life-course models have been infrequently applied to physical function. We sought to examine the effects of the cumulative burden of cardiovascular risk factors (CVRFs) from childhood on physical function in midlife.
This longitudinal study consisted of 718 participants (aged 37 to 56 years at follow-up) who were examined for CVRFs at least four times during childhood and at least twice in adulthood, with 39 years of follow-up. We assessed physical function in 2013-2016 with the Short Physical Performance Battery (SPPB), 6-minute walking test (6MWT), and handgrip strength. The area under the growth curve (AUC) was used as a measure of cumulative exposure to CVRFs during childhood.
AUC of HDL-cholesterol levels in childhood were positively associated with SPPB score. AUC levels of body mass index (BMI) and triglycerides (TG) were inversely associated with 6MWT. Higher AUC levels of systolic/diastolic blood pressure (BP) predicted poorer hand grip strength. The number of childhood CVRFs in the top quartile, including AUC levels of BMI and TG, were inversely associated with 6MWT and remained significant after adjustment for the adulthood CVRFs.
Cumulative burden of CVRFs from childhood were associated with worse physical function in midlife independent of adulthood CVRFs.
生命历程模型很少应用于身体功能。我们试图研究从儿童期开始的心血管危险因素（CVRF）累积负担对中年期身体功能的影响。
这项纵向研究包括 718 名参与者（随访时年龄为 37 至 56 岁），他们在儿童期至少进行了 4 次，在成年期至少进行了 2 次 CVRF 检查，随访时间为 39 年。我们在 2013-2016 年使用短体力量表（SPPB）、6 分钟步行测试（6MWT）和握力来评估身体功能。生长曲线下面积（AUC）被用作衡量儿童期 CVRF 累积暴露的指标。
儿童期高密度脂蛋白胆固醇（HDL-C）水平的 AUC 与 SPPB 评分呈正相关。BMI 和甘油三酯（TG）的 AUC 水平与 6MWT 呈负相关。较高的收缩压/舒张压（BP）AUC 水平预示着握力较差。包括 BMI 和 TG 的 AUC 水平在内的前四分之一儿童 CVRF 数量与 6MWT 呈负相关，并且在调整成年期 CVRF 后仍然显著。
儿童期 CVRF 的累积负担与中年期身体功能下降有关，独立于成年期 CVRF。
