Ramezankhani Azra, Mehrabi Yadollah, Azizi Fereidoun, Hosseinpanah Farhad, Dehghan Pooneh, Hadaegh Farzad
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Prev Med. 2023 Dec;177:107747. doi: 10.1016/j.ypmed.2023.107747. Epub 2023 Oct 26.
There are significant gaps in understanding of the association between levels and rate of change of body mass index (BMI) and blood pressure (BP) at different ages during childhood and carotid intima-media thickness (CIMT) in adulthood. We investigated the association between trajectories of BMI and BP from childhood to adulthood and adult CIMT among Iranian participants in the Tehran Lipid and Glucose Study (TLGS) cohort. A total of 1334 participants (692 men), from the TLGS cohort (1999-2018) with repeated measurements of BMI and BP (2-6 times) from childhood (3-18 years) to young adulthood (20-40 years) were selected. Trajectory parameters included levels and linear slopes of BMI and BP growth curve models, and cumulative burden defined as the area under those curves (AUC). After adjusting for confounders, AUC of BMI and diastolic blood pressure (DBP) were significantly associated with high CIMT in adulthood, with the standardized odds ratios (OR) and 95% confidence interval (95% CI) of 1.35 (1.12-1.62) and 1.27 (1.01-1.60), respectively. Associations between level-independent slopes of BMI and adult CIMT were significantly positive (ORs: 1.27 to 1.26) during childhood ages (3-18 years). Further, levels of BMI (ORs: 1.23 to 1.29) and DBP (ORs: 1.25 to 1.33) during the ages of 13-18 and 11-17 years, respectively, were significantly associated with CIMT in adulthood (all P < 0.05). The cumulative burden of BMI and DBP was associated with CIMT in adulthood. Adolescence is a crucial period for high CIMT, which has implications for early prevention of atherosclerosis.
在儿童期不同年龄阶段的体重指数（BMI）水平及变化率与血压（BP）和成年期颈动脉内膜中层厚度（CIMT）之间关联的理解上存在显著差距。我们在德黑兰血脂与血糖研究（TLGS）队列的伊朗参与者中，调查了从儿童期到成年期的BMI和BP轨迹与成年CIMT之间的关联。从TLGS队列（1999 - 2018年）中选取了1334名参与者（692名男性），他们从儿童期（3 - 18岁）到青年期（20 - 40岁）重复测量了BMI和BP（2 - 6次）。轨迹参数包括BMI和BP生长曲线模型的水平及线性斜率，以及定义为这些曲线下面积（AUC）的累积负担。在调整混杂因素后，BMI和舒张压（DBP）的AUC与成年期高CIMT显著相关，标准化比值比（OR）和95%置信区间（95%CI）分别为1.35（1.12 - 1.62）和1.27（1.01 - 1.60）。在儿童期（3 - 18岁），BMI与成年CIMT的非水平依赖性斜率之间的关联显著为正（OR值：1.27至1.26）。此外，分别在13 - 18岁和11 - 17岁时的BMI水平（OR值：1.23至1.29）和DBP水平（OR值：1.25至1.33）与成年期CIMT显著相关（所有P < 0.05）。BMI和DBP的累积负担与成年期CIMT相关。青春期是高CIMT的关键时期，这对动脉粥样硬化的早期预防具有重要意义。
