儿童青少年生命早期因素与心血管代谢风险的关联

Association between early-life factors and cardiometabolic risk factors in children and adolescents

目的 了解影响儿童青少年心血管代谢风险的生命早期因素,为抑制儿童青少年高血压、糖尿病等心血管代谢危险因素提供有效措施。方法 选取“厦门市青春期发育队列”2020年随访调查中体格检查信息及血生化检测信息完整,且有生命早期信息的研究对象1 197名。生命早期信息与社会人口学信息通过问卷调查获得,心血管代谢指标通过体格检查和血生化检测获得。调整性别、年龄、家族史后,采用Logistic回归分析影响心血管代谢风险的生命早期因素。结果 厦门市儿童青少年心血管代谢风险聚集的检出率为17.96%,男生(26.67%)高于女生(9.64%),差异有统计学意义(χ^(2)=57.69,P<0.01)。每增加1项生命早期危险因素,发生一般性肥胖的风险增加0.35倍(OR=1.35,95%CI=1.03~1.78,P<0.05)。过期妊娠是心血管代谢风险的主要生命早期因素,与心血管代谢风险聚集(OR=2.45,95%CI=1.11~5.41)和高三酰甘油(OR=3.25,95%CI=1.39~7.61)的风险增加相关(P值均<0.05)。结论 儿童青少年心血管代谢风险升高与生命早期不利因素相关。应重点关注过期妊娠这一生命早期因素、肥胖这一心血管代谢风险,控制生命早期不利因素可以促进心脑血管疾病的零级预防。

Objective To understand the early-life factors that influence cardiometabolic risk factors in children and adolescents,so as to provide effective measures to curb cardiometabolic risk factors such as hypertension and diabetes in children and adolescents.Methods Data were sourced from the 2020 follow-up survey of the Xiamen Adolescent Development Cohort.The study involved 1197 subjects for whom completed anthropometric examination and blood biochemistry testing data,as well as early-life data.Early-life and sociodemographic data were obtained through questionnaire surveys,while cardiometabolic indicator data were sourced through physical examinations and blood testing.Logistic regression analysis was performed to analyze the impact of early-life factors on the cardiometabolic risk factors after adjusting for gender,age,and family history.Results The prevalence rate of cardiometabolic risk factors clustering in children and adolescents in Xiamen was 17.96%,with boys(26.67%)reporting higher rates than girls(9.64%),and the difference was statistically significant(χ^(2)=57.69,P<0.01).For every additional early-life risk factor,the risk factors of obesity increased 0.35 times(OR=1.35,95%CI=1.03-1.78,P<0.05).Post-term pregnancy may be a primary early-life risk factors for cardiometabolic risk factors,and it was associated with an increased risk of cardiometabolic risk factors clustering(OR=2.45,95%CI=1.11-5.41)and high triglycerides(OR=3.25,95%CI=1.39-7.61)(P<0.05).Conclusion Increased cardiometabolic risk factors in youth is associated with early-life adverse factors.It is crucial to pay greater attention to post-term pregnancy as an early-life factor and to consider obesity as a cardiometabolic risk factors.Controlling early-life adverse factors is important for the prevention of cardiovascular disease.