Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland;
Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
Pediatrics. 2021 Mar;147(3). doi: 10.1542/peds.2020-016691. Epub 2021 Feb 8.
Cardiovascular risk factors, such as obesity, blood pressure, and physical inactivity, have been identified as modifiable determinants of left ventricular (LV) diastolic function in adulthood. However, the links between childhood cardiovascular risk factor burden and adulthood LV diastolic function are unknown. To address this lack of knowledge, we aimed to identify childhood risk factors associated with LV diastolic function in the participants of the Cardiovascular Risk in Young Finns Study.
Study participants ( = 1871; 45.9% men; aged 34-49 years) were examined repeatedly between the years 1980 and 2011. We determined the cumulative risk exposure in childhood (age 6-18 years) as the area under the curve for systolic blood pressure, adiposity (defined by using skinfold and waist circumference measurements), physical activity, serum insulin, triglycerides, total cholesterol, and high- and low-density lipoprotein cholesterols. Adulthood LV diastolic function was defined by using E/é ratio.
Elevated systolic blood pressure and increased adiposity in childhood were associated with worse adulthood LV diastolic function, whereas higher physical activity level in childhood was associated with better adulthood LV diastolic function ( < .001 for all). The associations of childhood adiposity and physical activity with adulthood LV diastolic function remained significant (both < .05) but were diluted when the analyses were adjusted for adulthood systolic blood pressure, adiposity, and physical activity. The association between childhood systolic blood pressure and adult LV diastolic function was diluted to nonsignificant ( = .56).
Adiposity status and the level of physical activity in childhood are independently associated with LV diastolic function in adulthood.
肥胖、血压和身体活动不足等心血管危险因素已被确定为成年人心室舒张功能的可改变决定因素。然而，儿童时期心血管危险因素负担与成年人心室舒张功能之间的联系尚不清楚。为了解决这方面的知识空白，我们旨在确定心血管风险在芬兰年轻人研究中的参与者的童年时期的危险因素与成年人心室舒张功能之间的关系。
研究参与者（n=1871；45.9%为男性；年龄 34-49 岁）在 1980 年至 2011 年期间进行了多次检查。我们通过测量皮褶厚度和腰围来确定儿童时期（6-18 岁）的累积风险暴露，作为收缩压、肥胖（通过皮褶和腰围测量定义）、身体活动、血清胰岛素、甘油三酯、总胆固醇、高低密度脂蛋白胆固醇的曲线下面积。成年人心室舒张功能通过 E/é 比值来定义。
儿童时期的收缩压升高和肥胖增加与成年人心室舒张功能较差有关，而儿童时期的身体活动水平较高与成年人心室舒张功能较好有关（所有 P<0.001）。儿童肥胖和身体活动与成年人心室舒张功能的关联仍然显著（均 P<0.05），但当分析调整为成年收缩压、肥胖和身体活动时，这种关联被稀释。儿童时期收缩压与成年人心室舒张功能的关联被稀释至无统计学意义（P=0.56）。
儿童时期的肥胖状况和身体活动水平与成年人心室舒张功能独立相关。
