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一种评估幼儿亚临床心血管疾病的母婴二元方法:一项可行性研究。

A Mother-Child Dyadic Approach to Evaluating Subclinical Cardiovascular Disease in Young Children: A Feasibility Study.

作者信息

Muchira James M, Mogos Mulubrhan F, Park Chorong, Logan Jeongok, Piano Mariann R

出版信息

J Cardiovasc Nurs. 2024;39(4):307-317. doi: 10.1097/JCN.0000000000000944. Epub 2022 Sep 2.

Abstract

BACKGROUND

Cardiovascular (CV) risk factors can be transmitted from mothers to their children. However, it is challenging to measure and identify subclinical CV risk in young children using traditional CV risk methods and metrics.

OBJECTIVE

The purpose of this study was to determine the feasibility of recruiting mother-child dyads and measuring arterial stiffness (pulse wave velocity, augmentation index/pressure), blood pressure (BP), BP circadian pattern, specifically nocturnal BP dipping, and CV health metrics in mothers and in children aged 1 to 5 years.

METHODS

All BP and arterial stiffness measures were obtained using the noninvasive automated oscillometric Mobil-O-Graph device. Also measured were blood cholesterol level; glucose level; body mass index (BMI); and smoking, diet, and physical activity history. Descriptive statistics were used for assessing recruitment feasibility and Pearson correlations for mother-child associations.

RESULTS

Thirty-five mother-child dyads completed the protocol. Recruitment reach was 89% and retention rate was 80%. Mothers were 34.3 ± 5.4 years old with a mean systolic BP (SBP) of 114.6 ± 9.5 mm Hg and BMI of 26.0 ± 6.5. Children were 3 ± 1.4 years old with a mean SBP of 103.3 ± 9.4 mm Hg and BMI z -scores of -0.3 ± 1.5. Arterial stiffness parameters were within normal ranges for mothers and children. Twenty-three percent of mothers did not exhibit nocturnal dipping (<10% decrease between day and nighttime SBP). Maternal SBP was positively correlated with child BMI z -scores ( r = 0.42, P = .022) as well as mother-child augmentation pressure ( r = 0.51, P = .010).

CONCLUSIONS

Our findings support using a mother-child approach and novel noninvasive approaches to assess and target CV risk in mothers and their young children.

摘要

背景

心血管(CV)危险因素可从母亲传递给子女。然而,使用传统的CV风险方法和指标来测量和识别幼儿的亚临床CV风险具有挑战性。

目的

本研究的目的是确定招募母婴对并测量母亲和1至5岁儿童的动脉僵硬度(脉搏波速度、增强指数/压力)、血压(BP)、血压昼夜模式,特别是夜间血压下降以及CV健康指标的可行性。

方法

所有血压和动脉僵硬度测量均使用无创自动示波Mobil-O-Graph设备获得。还测量了血胆固醇水平、血糖水平、体重指数(BMI)以及吸烟、饮食和体育活动史。描述性统计用于评估招募可行性,Pearson相关性用于评估母婴关联。

结果

35对母婴完成了方案。招募成功率为89%,保留率为80%。母亲年龄为34.3±5.4岁,平均收缩压(SBP)为114.6±9.5 mmHg,BMI为26.0±6.5。儿童年龄为3±1.4岁,平均SBP为103.3±9.4 mmHg,BMI z评分为-0.3±1.5。母亲和儿童的动脉僵硬度参数在正常范围内。23%的母亲未表现出夜间血压下降(白天和夜间SBP之间下降<10%)。母亲的SBP与儿童BMI z评分呈正相关(r = 0.42,P = 0.022),以及母婴增强压力呈正相关(r = 0.51,P = 0.010)。

结论

我们的研究结果支持采用母婴方法和新型无创方法来评估和针对母亲及其幼儿的CV风险。

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