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Dangantakar da ke tsakanin ingantacciyar lafiyar zuciya da jijiyoyin jini da nau'in halittar jini na uwaye masu kiba da 'ya'yansu masu shekaru 6
Marubuta: Litwin L, Sundholm JKM, Meinilä J, Kulmala J, Tammelin TH, Rönö K, Koivusalo SB, Eriksson JG, Sarkola T
Linda Litwin,1,2 Johnny KM Sundholm,1,3 Jelena Meinilä,4 Janne Kulmala,5 Tuija H Tammelin,5 Kristiina Rönö,6 Saila B Koivusalo,6 Johan G Eriksson,7–10 Taisto Sarkola1,31Asibitin Yara, Jami'ar Jami'ar Helsinki da Asibitocin Jami'ar Helsinki, Helsinki, Finland;2 Sashen Ciwon Zuciya na Ciwon Zuciya da Ilimin Jiki na Yara, Jami'ar Kiwon Lafiya ta Silesian, Katowice, Poland, Zabrze FMS;3 Cibiyar Nazarin Kiwon Lafiya ta Minerva Foundation, Helsinki, Finland;4 Sashen Abinci da Gina Jiki, Jami'ar Helsinki, Helsinki, Finland;5LIKES Ayyukan Wasanni da Cibiyar Nazarin Lafiya, Jyvaskyla, Finland;6 Asibitin Mata na Jami'ar Helsinki da Asibitin Jami'ar Helsinki a Helsinki, Finland;7 Cibiyar Bincike ta Folkhälsan, Helsinki, Finland;8 Jami'ar Helsinki da Sashen Kula da Lafiya na Farko na Helsinki, Asibitin Jami'ar, Helsinki, Finland;9 Shirin Bincike na Canjin Canjin Mutum da Ma'aikatar Harkokin Ciwon Haihuwa da Gynecology, Makarantar Magunguna ta Yang Luling, Jami'ar Kasa ta Singapore, Singapore;10 Cibiyar Kimiyyar Kiwon Lafiya ta Singapore (SICS), Kimiyya, Fasaha da Ofishin Bincike (A*STAR), Harkokin Sadarwar Singapore: Linda Litwin Ma'aikatar Ciwon Zuciya da Ciwon Zuciya, Zabrze FMS, Jami'ar Kiwon Lafiya ta Silesian, M.Sklodowskiej-Curie 9, Zabrze, 41-800, Poland Tel +48 322713401 Fax +48 322713401 Imel [email protected] Fage: Halittar Halittu da salon rayuwar iyali na iya haifar da haɗarin zuciya da jijiyoyin jini, amma gwargwadon abin da suke shafar tsari da aikin arteries a ƙuruciya shine m.Mun yi nufin tantance alaƙa tsakanin ingantacciyar lafiyar zuciya da jijiyoyin jini a cikin yara da iyaye mata, atherosclerosis subclinical na mahaifa, da cututtukan jijiya a cikin yara.Hanyoyi: Daga Nazarin Rigakafin Ciwon Ciwon sukari na Finnish (RADIEL) ƙungiyar tsayin daka, bincike mai zurfi na 201 uwa-yara yara a 6.1 ± 0.5 shekaru da aka kiyasta kiwon lafiya na zuciya da jijiyoyin jini (BMI, hawan jini, glucose jini mai azumi, jimlar cholesterol, ingancin rage cin abinci, Ayyukan jiki, shan taba), abun da ke ciki na jiki, carotid ultra-high mita duban dan tayi (25 da 35 MHz) da bugun bugun jini.Sakamako: Mun gano cewa babu wata alaƙa tsakanin kyakkyawar lafiyar zuciya da jijiyoyin jini na yaro da mahaifiyar, amma an ba da rahoton shaida game da alaƙar takamaiman alamomi: jimlar cholesterol (r=0.24, P=0.003), BMI (r=0.17, P) = 0.02), karfin jini na diastolic (r=0.15, P=0.03) da ingancin abinci (r=0.22, P=0.002).phenotype na jijiyoyin bugun jini na yara ba shi da alaƙa da ingantaccen lafiyar zuciya na yaro ko uwa.A cikin nau'in fassarar koma-baya mai yawa wanda aka daidaita don jinsi na yara, shekaru, hawan jini na systolic, kitsen jiki, da yawan kitse na jiki, kauri na intima-media na carotid artery a cikin yara an haɗa shi da kansa kawai tare da kauri na intima na mahaifa carotid artery intima. -media (ƙararar 0.1 mm [95%) CI 0.05, 0.21, P = 0.001] Kaurin intima-kafofin watsa labaru na carotid na mahaifa ya karu da 1 mm).Yara iyaye mata tare da atherosclerosis na subclinical sun rage raguwar bugun jini na carotid (1.1 ± 0.2 vs 1.2 ± 0.2% / 10 mmHg, P = 0.01) da ƙara yawan kauri na intima-media na carotid (0.37 ± 0.04 vs 0.35) ± 0.006 mm, P Ƙarshe: Mahimman alamun kiwon lafiyar zuciya da jijiyoyin jini suna da alaƙa iri-iri ga uwa da yaro a farkon ƙuruciya.Ba mu sami wata shaida na tasirin ingantaccen lafiyar yara ko mahaifiyarsu akan cututtukan jijiya na yara ba.Kaurin kaurin intima-media na mahaifa na iya yin hasashen kaurin intima-media na carotid artery a cikin yara, amma tsarinsa har yanzu ba a bayyana ba.Atherosclerosis na mahaifa na subclinical yana da alaƙa da taurin jijiyoyin carotid na gida a farkon ƙuruciya.Mahimman kalmomi: cututtuka na zuciya da jijiyoyin jini, atherosclerosis, carotid artery intima-media kauri, abubuwan haɗari, yara
Abubuwan haɗarin cututtukan zuciya na al'ada suna ba da gudummawa ga abin da ya faru da haɓakar atherosclerosis.1,2 Abubuwan haɗari suna yin tari tare, kuma haɗin su yana da alama ya fi tsinkaya haɗarin cututtukan zuciya ɗaya.3
Ƙungiyar Zuciya ta Amirka ta bayyana kyakkyawar lafiyar zuciya da jijiyoyin jini (ICVH) a matsayin saiti na alamun kiwon lafiya guda bakwai (BMI), hawan jini (BP), glucose na jini mai azumi, jimlar cholesterol, ingancin abinci, aikin jiki, shan taba) don inganta haɓaka. rigakafin cututtukan zuciya a cikin yara da manya.4 IVH yana da alaƙa mara kyau tare da atherosclerosis subclinical a cikin girma.5 ICVH da ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun abubuwan da ke faruwa na cututtukan zuciya da mace-mace a cikin manya.6-8
Cutar cututtukan zuciya na iyaye suna ƙara haɗarin abubuwan da ke faruwa na zuciya a cikin zuriya.9 Abubuwan da ke da alaƙa da muhalli da ke da alaƙa da kwayoyin halitta da salon rayuwa na gama gari ana ɗaukarsu azaman hanyoyin da za a iya amfani da su, amma har yanzu ba a tantance gudunmawar su ba.10,11
Dangantaka tsakanin iyaye da yaro IVH ya riga ya bayyana a cikin yara masu shekaru 11-12.A wannan mataki, ICVH na yara yana da alaƙa da haɓakar jijiya na carotid kuma yana da alaƙa da mummunan alaƙa da saurin bugun bugun jini na mahaifa (PWV), amma ba a bayyana a cikin kauri na intima-media na carotid artery (IMT).12 Duk da haka, haɗarin cututtukan zuciya na zuciya tsakanin shekaru 12-18 yana haɗuwa da karuwa a cikin carotid IMT a cikin rayuwa ta tsakiya, kuma ba shi da dangantaka da abubuwan haɗari a cikin lokaci guda.13 Ba a rasa tabbaci game da ƙarfin waɗannan ƙungiyoyin a ƙuruciya.
A cikin aikinmu na baya, ba mu sami tasirin ciwon sukari na gestational ko tsarin rayuwar mahaifiya ba akan ilimin yara na yara, tsarin jiki ko girman jijiya da aiki.14 Mayar da hankali na wannan bincike shine yanayin ƙetare-tsare na haɗuwar haɗarin zuciya da jijiyoyin jini.Aji da tasirinsa akan phenotype na arterial na yara.Muna tsammanin cewa ICVH na uwa da jijiyoyi masu maye gurbin cututtukan zuciya za su kasance a cikin ICVH na ƙuruciya da cututtukan jijiya a farkon ƙuruciya.
Bayanan ƙetare sun fito ne daga bin diddigin shekaru shida na Nazarin Rigakafin Ciwon Ciwon Suga na Finnish (RADIEL).An gabatar da ƙirar bincike na farko a wani wuri.15 A takaice, matan da suka yi shirin yin ciki ko kuma suna cikin rabin farko na ciki kuma suna da haɗarin kamuwa da ciwon sukari na ciki (kiba da / ko tarihin ciwon sukari na ciki) an dauki su (N=728).An tsara tsarin bibiyar cututtukan zuciya na shekaru 6 a matsayin nazari na lura da nau'i-nau'i na uwa da jarirai, tare da adadin adadin uwaye da kuma ba tare da ciwon sukari na ciki ba, tare da ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙungiyoyi (~ 200).Daga watan Yuni 2015 zuwa Mayu 2017, an aika da gayyata ta ci gaba ga mahalarta har sai an kai iyaka, kuma an dauki nau'i-nau'i na 201 na biyu-tuples.An tsara abin da ya biyo baya ga yara masu shekaru 5-6 don tabbatar da haɗin gwiwa ba tare da kwantar da hankali ba, ciki har da ƙima na ƙungiyar binaryar uwa-jarirai game da girman jiki da abun da ke ciki, hawan jini, glucose na jini mai azumi da lipids na jini, aikin jiki ta amfani da accelerometers, ingancin abinci da kuma kayan aiki. Tambayoyin shan taba (mata), hanyoyin jini Duban dan tayi da ma'aunin matsa lamba na intraocular da echocardiography a cikin yara.An jera samuwar bayanai a cikin ƙarin Tebura S1.Kwamitin Da'a na Ma'aikatan Lafiyar Jiki da Gynecology, Likitan Yara da Ilimin Halitta na Asibitin Jami'ar Helsinki ya amince da ka'idar bincike (20/13/03/03/2015) don kimantawa na shekaru shida.An samu duk bayanan yarda a rubuce a lokacin rajista.An gudanar da binciken ne bisa ga sanarwar Helsinki.
ƙwararren mai bincike (TS) yana amfani da 25 MHz da 35 MHz transducers tare da tsarin Vevo 770, kuma yana amfani da UHF22, UHF48 (irin mitar cibiyar) da tsarin Vevo MD (VisualSonics, Toronto, Kanada) azaman nau'i-nau'i na 52 na ƙarshe na uwa da yaro.An zana jijiyar carotid na kowa 1 cm kusa da kwararan fitila na carotid na biyu, kuma wurin hutawa yana cikin matsayi na baya.Yi amfani da mafi girman mita wanda zai iya hango bango mai nisa don samun hotuna masu inganci masu inganci waɗanda ke rufe zagayowar zuciya 3-4.Yi amfani da Vevo 3.0.0 (Vevo 770) tare da na'urorin lantarki na hannu da software na VevoLab (Vevo MD) don nazarin hotunan layi.16 Lumen diamita da IMT an auna su ta hanyar gogaggen mai lura (JKMS) a ƙarshen diastole ta amfani da dabarun yankan, rashin sanin halayen batutuwa (Ƙarin Hoto S1).Mun riga mun bayar da rahoton cewa intra-observer coefficient na bambancin auna ta matsananci-high-ƙuduri duban dan tayi a cikin yara da manya shine 1.2-3.7% a cikin lumen diamita, IMT ne 6.9-9.8%, da inter-observer coefficient na bambancin ne. 1.5-4.6% a cikin lumen diamita., 6.0-10.4% na IMT.Makin carotid IMT Z da aka daidaita don shekaru da jinsi an ƙididdige su ta amfani da ma'anar fararen lafiyayyen yara marasa kiba.17
An auna diamita na jijiya na lumen a mafi girman systole da ƙarshen-diastole don kimanta ma'anar carotid artery β stiffness index da haɓakar haɓakar artery carotid.Yin amfani da maƙalli mai girman da ya dace, hanyar oscillometric (Dinamap ProCare 200, GE) an yi amfani da shi don yin rikodin hawan jini na systolic da diastolic don ƙididdige aikin na roba yayin hoton duban dan tayi a cikin matsayi na hannun dama.Ana ƙididdige ƙididdigar haɓakar haɓakar jijiya na carotid da jigon jijiya β-ƙumburi daga jijiyar carotid ta amfani da dabara mai zuwa:
Daga cikin su, CCALAS da CCALAD sune yanki na carotid artery lumen na kowa yayin systole da diastole bi da bi;CCALDS da CCALDD sune diamita na carotid artery lumen gama gari yayin systole da diastole bi da bi;SBP da DBP su ne systolic da diastolic hawan jini.18 Matsakaicin bambance-bambancen haɓakar haɓakar haɓakar jijiyoyin bugun jini a cikin mai lura shine 5.4%, ƙimar bambance-bambancen jigon carotid β stiffness index shine 5.9%, kuma madaidaicin tsaka-tsakin tsaka-tsaki na bambance-bambancen haɓakar jijiyoyin carotid shine 11.9% coefficient. da 12.8% na carotid artery β stiffness index.
An yi amfani da babban ƙuduri na gargajiya na gargajiya Vivid 7 (GE) sanye take da mai jujjuya layin layi na 12 MHz don ƙara tantance jijiyar carotid na mahaifa don plaque.An fara daga jijiya na carotid na kowa kusa da kwan fitila, ana yin gwajin jini na carotid ta hanyar bifurcation da kuma ɓangaren kusa na ciki da waje na carotid arteries.Dangane da ijma'in Mannheim, an ayyana plaque azaman 1. Kauri na gida na bangon jirgin ruwa da 0.5 mm ko 50% na kewayen IMT ko 2. Jimlar kaurin bangon jijiya ya wuce mm 1.5.19 An tantance kasancewar plaque ta hanyar dichotomy.Mai sa ido na farko (JKMS) da kansa yana yin maimaita ma'auni akan sashe na hotuna (N = 40) don kimanta bambancin intra-observer, kuma mai lura na biyu (TS) yana kimanta bambance-bambancen masu lura da juna.Cohen κ na intra-observer variability da tsaka-tsakin masu kallo sun kasance 0.89 da 0.83, bi da bi.
An auna PWV ta hanyar horar da ma'aikacin bincike don tantance taurin jini na yanki ta hanyar amfani da firikwensin injiniya (Complior Analyse, Alam Medical, Saint-Quentin-Fallavier, Faransa) yayin da yake hutawa a cikin matsayi.20 Ana sanya na'urori masu auna firikwensin a kan madaidaicin carotid artery, radial radial artery, da kuma madaidaicin jijiyar mace don kimanta tsakiya (dama carotid artery-femoral artery) da na gefe (dama carotid artery-radial artery) lokacin wucewa.Yi amfani da ma'aunin tef don auna nisa kai tsaye tsakanin wuraren rikodi zuwa mafi kusa 0.1 cm.Matsakaicin nisan jijiya na mata na carotid dama yana ninka da 0.8 sannan kuma ana amfani dashi a tsakiyar lissafin PWV.Maimaita rikodin a cikin matsayi na baya.An samu rikodin biyu lokacin da aka yi rikodin na uku a cikin saiti inda bambanci tsakanin ma'auni ya fi 0.5 m/s (10%).A cikin saitin ma'auni fiye da biyu, ana amfani da sakamakon tare da mafi ƙarancin ƙimar haƙuri don bincike.Haƙuri wani ingantacciyar siga ce wacce ke ƙididdige canjin bugun bugun jini yayin yin rikodi.Yi amfani da matsakaicin aƙalla ma'auni biyu a cikin bincike na ƙarshe.Ana iya auna PWV na yara 168.Ƙididdigar bambancin ma'auni na maimaitawa shine 3.5% na carotid-femoral artery PWV da 4.8% na carotid-radial artery PWV (N=55).
Ana amfani da saitin alamomin binary guda uku don yin la'akari da atherosclerosis subclinical uwa: kasancewar plaque carotid artery plaque, carotid artery IMT daidaita shekaru kuma ya wuce kashi 90 a cikin samfurin mu, kuma fiye da kashi 90 PWV na wuyansa da femur sun dace. tare da shekaru da kuma mafi kyau duka hawan jini.ashirin da daya
ICVH saitin alamomin binary 7 ne tare da kewayon tarawa daga 0 zuwa 7 (mafi girman maki, mafi yawan daidai da jagororin).4 Alamomin IVCH da aka yi amfani da su a cikin wannan binciken sun yi daidai da ma'anar asali (an yi gyare-gyare guda uku) -Ƙarin Tebura S2) kuma sun haɗa da:
Ana kimanta ingancin abincin ta Fihirisar Cin Kofin Lafiyar Yara ta Finnish (kewaye 1-42) da ma'aunin abinci mai lafiya na uwa (kewaye 0-17).Duka fihirisa sun rufe 4 na nau'ikan nau'ikan 5 da aka haɗa a cikin alamar abinci na asali (sai dai shan sodium).23,24 Mahimmancin ƙimar inganci da ingancin abinci mara kyau an bayyana shi azaman 60% ko fiye don nuna ingancin abincin na asali.Ma'anar alama (yana da kyau idan an cika fiye da 3 na 5).Dangane da yawan yara na yara na Finnish lafiya kwanan nan (87.7% na 'yan mata, 78.2% na maza), idan an wuce ƙayyadaddun ƙayyadaddun jinsi na yara masu kiba, BMI na yaron an ayyana shi azaman mara kyau, wanda ya ɗan bambanta da 85. % na yawan mutanen Finnish.22 Saboda yawan barin makaranta da ƙarancin ƙima (Ƙarin Teburin S1, 96% na iyaye mata sun cika ka'idojin ICVH), an cire aikin jiki na masu juna biyu da na kwance.An rarraba ICVH a zahiri zuwa nau'ikan masu zuwa: ƙananan (yara 0-3, uwaye 0-2), matsakaici (yara 4, uwaye 3-4) da babba (yara da uwa 5-6), yana ba da damar kwatanta nau'ikan daban-daban. .
Yi amfani da kayan lantarki (Seca GmbH & Co. KG, Jamus) don auna tsayi da nauyi zuwa 0.1 cm mafi kusa da 0.1 kg.An samar da makin BMI Z na yara tare da la'akari da saitin bayanan yawan mutanen Finnish na baya-bayan nan.Haɗin jiki 22 sun wuce kima na rashin ƙarfi na bioelectrical impedance (InBody 720, InBody Bldg, Koriya ta Kudu).
An auna hawan jini mai hutawa ta hanyar oscillometric daga hannun dama a cikin wurin zama (Omron M6W, Omron Healthcare Europe BV, Netherlands) tare da isasshen cuff.Matsakaicin matsakaicin systolic da diastolic ana ƙididdige su daga ma'auni biyu mafi ƙanƙanta (ƙananan ma'auni uku).Ana ƙididdige ƙimar hawan jini na yara Z bisa ga jagororin.25
An tattara samfuran jini na glucose na plasma da lipids a ƙarƙashin yanayin azumi.Sakamako daga yara 3 tare da rashin tabbas azumi (mafi yawan triglycerides, glucose jini mai azumi, da haemoglobin glycosylated A1c (HbA1c)) an cire su daga binciken.Total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol da triglycerides an ƙaddara ta hanyar enzymatic, glucose plasma da enzymatic hexokinase ƙaddara, da HbA1c da immunoturbidimetric analyzer (Roche Diagnostics, Basel, Switzerland) don kimantawa. .
An tantance abincin da mahaifiyar ta yi ta hanyar tambayoyin mitar abinci kuma an ƙara tantance ta da ma'aunin abinci mai kyau.A baya an inganta Fihirisar Abincin Abinci mai Lafiya a matsayin kayan aiki mai amfani don yin la'akari da yarda da Shawarar Nutrition na Nordic 26 a cikin rukunin RADIEL na asali.24 A takaice, tana dauke da sinadarai 11, wadanda suka hada da cin kayan lambu, 'ya'yan itatuwa da berries, hatsi masu yawa, kifi, madara, cuku, mai dafa abinci, miya mai mai, kayan ciye-ciye, abubuwan sha masu zaki da abinci mai sauri.Mafi girman maki yana nuna mafi girman matakin yarda da shawarwarin.An tantance ingancin abinci na yara ta hanyar bayanan abinci na kwanaki 3 kuma an ƙara tantancewa ta Indexididdigar Cin Abinci na Yara na Finnish.A baya an tabbatar da Indexididdigar Abincin Lafiyar Yara ta Finnish a cikin yawan yaran yara na Finnish.23 Ya ƙunshi nau'ikan abinci guda biyar: kayan lambu, 'ya'yan itatuwa da berries;man fetur da margarine;abinci mai yawan sukari;kifi da kifi da kayan lambu;da madarar nono.An ƙididdige yawan abincin da ake amfani da shi ta yadda yawan abin da ake amfani da shi, shine mafi girman maki.Ban da abincin da ke ɗauke da sukari mai yawa, ana juya makin.Kafin zira kwallo, daidaita yawan kuzari ta hanyar raba abin da ake ci (grams) ta hanyar kuzarin kuzari (kcal).Mafi girman maki, mafi kyawun ingancin abincin yara.
Matsakaici zuwa motsa jiki mai ƙarfi (MVPA) an auna ta ta amfani da madaidaicin ƙarar hippoter (ActiGraph GT3X, ActiGraph, Pensacola, Amurka) da maɗaurin uwa (SenseWear ArmBand Pro 3).An umurce su da sanya na'ura a lokacin farkawa da lokacin barci, amma an cire lokacin barci daga bincike.Mai saka idanu na yaro yana tattara bayanai akan ƙimar samfurin 30 Hz.Yawancin lokaci ana tace bayanan, ana jujjuya su zuwa ƙididdige lokaci na daƙiƙa 10, kuma ana nazarin su ta amfani da madaidaicin yanke Evenson (2008) (≥2296 cpm).27 Mahaifiyar mai saka idanu tana tattara ƙimar MET a cikin zamanin 60 na biyu.Ana ƙididdige MVPA kamar yadda ƙimar MET ta wuce 3. Ana bayyana ma'auni mai inganci azaman aƙalla kwanakin aiki 2 da 1 karshen mako (rikodi aƙalla mintuna 480 a kowace rana) da kwanakin aiki 3 da ƙarshen mako 1 (ana yin rikodi aƙalla mintuna 720 kowace rana) don uwaAna ƙididdige lokacin MVPA azaman matsakaicin nauyi [(matsakaicin mintuna MVPA/rana akan kwanakin mako × 5 + matsakaicin mintuna MVPA/rana a ƙarshen mako × 2)/7], ƙari, a matsayin kashi na jimlar lokacin sawa.An yi amfani da bayanan ayyukan motsa jiki na baya-bayan nan na yawan mutanen Finnish azaman tunani.28
An yi amfani da takardar tambayoyin don samun bayanai game da shan taba uwar, cututtuka masu tsanani, magunguna, da ilimi.
Ana bayyana bayanai azaman ma'anar ± SD, tsaka-tsaki (kewayon tsaka-tsaki) ko ƙidaya (kashi).Ƙimar rarrabuwar al'ada na duk masu canji masu ci gaba bisa ga ma'auni da makircin QQ na al'ada.
Mai zaman kanta samfurin t gwajin, gwajin Mann-Whitney U, bincike guda ɗaya na bambance-bambance, Kruskal-Wallis, da gwajin chi-square an yi amfani da su kamar yadda ya dace don ƙungiyoyin kwatanta (mahaifiya da yaro, yaro da yarinya, ko ƙananan da matsakaici da babban ICVH). ).
An yi amfani da ƙimar haɗin kai na Pearson ko Spearman don bincika ƙungiyar univariate tsakanin halayen yaro da uwa.
An yi amfani da tsarin jujjuyawar layin multivariate don kafa samfurin bayani don HDL cholesterol na yara da carotid IMT.Zaɓuɓɓuka masu canzawa sun dogara ne akan daidaituwa da ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun, yana guje wa manyan ƙididdiga masu yawa a cikin ƙirar, kuma ya haɗa da abubuwan da za su iya rikicewa.Multicollinearity ana kimanta ta amfani da bambance-bambancen hauhawar farashin kaya, tare da matsakaicin ƙimar 1.9.An yi amfani da koma bayan layi mai yawa don nazarin hulɗar.
An saita P ≤ 0.05 mai nau'i biyu don zama mai mahimmanci, sai dai a cikin nazarin daidaituwa na ƙaddarar ƙwayar carotid IMT a cikin yara tare da P ≤ 0.01.
Ana nuna halayen mahalarta a cikin Table 1 da Ƙarin Tebura S3.Idan aka kwatanta da yawan tunani, ƙimar BMI Z na yara da maki BP Z ya ƙaru.Ayyukanmu na baya sun ba da cikakkun bayanai game da ilimin halittar jini a cikin yara.14 Yara 15 (12%) ne kawai da 5 (2.7%) iyaye mata sun cika dukkan sharuɗɗan ICVH (Ƙarin Figures 2 da 3, Ƙarin Tables S4-S6).
Makin IVH na uwa da jarirai yana da alaƙa kawai ga samari (maza: rs=0.32, P=0.01; 'yan mata: rs=-0.18, P=0.2).Lokacin da aka yi nazari a matsayin mai ci gaba mai canzawa, bincike na haɗin kai na uwa-jarirai yana da ma'ana mai mahimmanci a cikin ma'aunin lipids na jini, HbA1C, kiba, hawan jini na diastolic, da ingancin abinci (Ƙarin Figures S4-S10).
Yara da mahaifiyar LDL, HDL, da jimlar cholesterol suna da alaƙa (r=0.23, P=0.003; r=0.35, P<0.0001; r=0.24, P=0.003, Figure 1).Lokacin da aka keɓance ta jinsin yaro, alaƙar da ke tsakanin LDL na yaro da mahaifiyarta da jimillar cholesterol ta kasance mai mahimmanci a cikin maza kawai (Ƙarin Tebura S7).Triglycerides da HDL cholesterol suna da alaƙa tare da adadin kitsen jikin 'yan mata (rs=0.34, P=0.004; r=-0.37, P=0.002, bi da bi, Hoto 1, Karin Bayani S8).
Hoto 1 Dangantaka tsakanin lipids na jinin yaro da uwa.Rarraba makirci tare da layin koma baya na layi (95% tazarar amincewa);(AC) Matakan lipid na jini na uwa da jarirai;(D) Kashi na kitsen jikin yarinya da babban sinadarin lipoprotein cholesterol.Ana nuna sakamako mai mahimmanci a cikin m (P ≤ 0.05).
Takaitacce: LDL, ƙananan lipoprotein mai yawa;HDL, babban adadin lipoproteins;r, Pearson haɗin kai.
Mun gano cewa akwai alaƙa mai mahimmanci tsakanin HbA1C na yaro da mahaifiyar (r=0.27, P=0.004), amma ba shi da alaƙa da glucose na jini mai azumi (P=0.4).Makin BMI Z na yara, amma ba adadin kitsen jiki ba, yana da rauni sosai tare da BMI na uwa da kuma rabon kugu-zuwa hip (r=0.17, P=0.02; r=0.18, P=0.02, bi da bi).Ƙimar Z na hawan jini na diastolic na yara yana da alaƙa da rauni tare da hawan jini na diastolic na uwa (r=0.15, P=0.03).Ma'auni na lafiyar yara na Finnish yana da alaƙa da ma'aunin abinci mai lafiya na uwa (r=0.22, P 0.002).An lura da wannan dangantakar a cikin yara maza (r=0.31, P=0.001).
Bayan ban da iyaye mata waɗanda aka yi wa maganin hauhawar jini, hypercholesterolemia, ko hyperglycemia, sakamakon ya kasance daidai.
Ana nuna cikakken nau'in nau'in jijiya a cikin Ƙarin Tebura S9.Tsarin jijiyoyin jini na yara yana da zaman kansa daga halayen yara (Ƙarin Teburin S10).Ba mu lura da kowace ƙungiya tsakanin IVCH na ƙuruciya da tsarin jijiyoyin jini ko aiki ba.A cikin nazarin yara da aka tsara ta hanyar IMTZ maki, mun lura cewa carotid IMT Z yawancin yara da matsakaicin matsakaici kawai ya karu idan aka kwatanta da yara masu ƙananan maki (ma'anar ± SD; matsakaicin maki 0.41 ± 0.63 vs low score- 0.07 ± 0.71, P = 0.03, Ƙarin Tebura S11).
IVCH na uwa ba ta da alaƙa da nau'in jijiyoyi na yara (Ƙarin Tables S10 da S12).Yara da jijiyoyin carotid artery IMT suna da alaƙa (Hoto na 2), amma haɗin gwiwar uwa-yara tsakanin sigogin taurin jini daban-daban ba su da mahimmanci a ƙididdiga (Ƙarin Teburin 9, Ƙarin Hoto S11).A cikin nau'in fassarar maimaitawa da yawa wanda aka daidaita don jinsi na yara, shekaru, hawan jini na systolic, kitsen jiki, da yawan kitsen jiki, mater carotid IMT shine kawai tsinkaya mai zaman kanta na carotid IMT na yara (daidaita R2 = 0.08).Don kowane 1 mm karuwa a cikin carotid na mahaifa IMT, carotid carotid IMT ya karu da 0.1 mm (95% CI 0.05, 0.21, P = 0.001) (Ƙarin Table S13).Jinsin yaron bai rage wannan tasirin ba.
Hoto 2 Daidaita tsakanin kaurin intima-media artery carotid a cikin yara da uwaye.Rarraba makirci tare da layin koma baya na layi (95% tazarar amincewa);(A) carotid na uwa da na yaro IMT, (B) carotid na mahaifa IMT percentile da yaro carotid IMT z-maki.Ana nuna sakamako mai mahimmanci a cikin m (P ≤ 0.05).
Makin jini na mahaifa yana da alaƙa tare da ƙayyadaddun haɓakar haɓakar arteries na carotid da β stiffness index a cikin yara (rs=-0.21, P=0.007, rs=0.16, P=0.04, S10 Karin bayani, bi da bi).Yaran da aka haifa ga iyaye mata tare da ƙwayar jijiyoyin jini na 1-3 suna da ƙananan ƙididdiga na haɓakar ƙwayar carotid fiye da waɗanda aka haifa ga iyaye mata tare da maki na 0 (ma'anar ± daidaitattun daidaituwa, 1.1 ± 0.2 vs 1.2 ± 0.2% / 10 mmHg, P= 0.01) kuma akwai haɓaka don ƙara yawan ƙwayar carotid β stiffness index (median (IQR), 3.0 (0.7) da 2.8 (0.7), P = 0.052) da kuma carotid artery IMT (ma'anar ± SD, 0.37 ± 0.04 da 0.304 ± 0.35 ±). mm, P=0.06) (Hoto na 3), Ƙarin Tebura S14).
Hoto na 3 Nau'in jijiyar jijiyoyin jini na yara wanda aka daidaita ta makin jijiyoyin mahaifa.Ana bayyana bayanai azaman ma'ana + SD, P tare da samfurin t gwaji mai zaman kansa (A da C) da gwajin Mann-Whitney U (B).Ana nuna sakamako mai mahimmanci a cikin m (P ≤ 0.05).Makin jini na mahaifa: kewayon 0-3, saitin alamomin binary guda uku: kasancewar plaque carotid, kauri na intima-kafofin watsa labarai na carotid artery wanda aka daidaita ta shekaru kuma ya wuce 90% a cikin samfurin mu, da igiyar mahaifa-femoral bugun bugun jini. gudun ya wuce kashi 90 cikin dari sun dace da shekaru kuma mafi kyawun hawan jini.ashirin da daya
Makin mahaifa (ICVH, jijiyar jijiyoyin jini) da haɗin ƙididdiga na yara da na uwa ba su da alaƙa da nau'in jijiyar jijiya na yara (Ƙarin Teburin S10).
A cikin wannan bincike na yanki na iyaye mata da 'ya'yansu masu shekaru 6, mun bincika haɗin gwiwa tsakanin ICVH na yara, ICVH na uwa, da kuma mahaifa na subclinical atherosclerosis tare da tsari da aiki na arteries na yara.Babban abin da aka gano shi ne cewa kawai mahaifiyar mahaifa ta subclinical atherosclerosis, yayin da yara da uwaye na al'ada na zuciya da jijiyoyin jini dalilai ba su da alaka da m canje-canje a farkon yara na jijiyoyin bugun gini phenotypes.Wannan sabon fahimta game da haɓakar jijiyoyin jini na yara na ƙuruciya yana haɓaka fahimtarmu game da tasirin intergenerational na subclinical atherosclerosis.
Muna ba da rahoto game da raguwar raguwar bugun jini na carotid da kuma abubuwan da ke faruwa a cikin carotid artery beta stiffness da carotid artery IMT a cikin 'ya'yan uwaye masu ciwon zuciya da cututtukan zuciya.Koyaya, babu alaƙa kai tsaye tsakanin alamomin aikin jijiyoyin jini na uwa da jarirai.Muna tsammanin cewa haɗa plaque na uwa a cikin ma'aunin jijiyoyin jini yana ƙaruwa da ƙimar hasashenta sosai.
Mun lura da kyakkyawar dangantaka tsakanin carotid artery IMT a cikin yara da uwaye;duk da haka, tsarin har yanzu ba a san shi ba saboda carotid artery IMT a cikin yara ya kasance mai zaman kanta daga halaye na yaro da mahaifiyarsa.Ƙungiyar da ke tsakanin ƙimar IVH na yara da carotid IMT sun nuna rashin daidaituwa, saboda ba mu lura da wani bambanci tsakanin ƙananan IVH da babban ICVH ba.
Mun san cewa wasu dalilai na iya taka rawa, ciki har da kewayen kai na yara, wanda zai iya zama muhimmin ma'auni na girman carotid artery a farkon matakan girma.Bugu da ƙari, sakamakonmu na iya kasancewa ga abubuwan da ba a auna ba waɗanda ke shafar ci gaban jijiyoyin tayi.Duk da haka, a baya mun bayar da rahoton cewa kafin haihuwa kiba / kiba da ciwon sukari na ciki ba su da wani tasiri a kan carotid yara IMT.14 Ƙarin bincike ya zama dole don gano tasirin tsarin jijiya da aiki akan haɓakar yara da asalin halittarsu.
Ƙungiyoyin da aka ruwaito sun kasance daidai da binciken da aka yi a baya a cikin matasa, wanda ya ba da shaida na ƙungiyoyi tsakanin iyaye-yara na jijiyoyin jini, ciki har da carotid IMT, ko da yake ba a daidaita girman jiki a cikin bincike ba.29 Babban gado na carotid IMT yana ƙara tabbatar da wannan da taurin jijiya babba.30,31
Ƙungiyar da aka lura tsakanin atherosclerosis na subclinical na mahaifa da kuma phenotype na jijiyoyin jini na yara ba a tsawaita ta ICVH na uwa ba.Wannan ya yi daidai da binciken da aka yi a baya wanda aka bayyana babban ɓangare na bambance-bambance a cikin phenotype na jijiyoyin jini na yara ta hanyar kwayoyin halitta masu zaman kansu daga abubuwan haɗari na zuciya da jijiyoyin jini na al'ada na iyaye da yara.29
Bugu da ƙari, sauye-sauye na jijiyoyi da aka lura ba su da dangantaka da ICVH na yara, yana nuna babban tasiri na asali na ƙananan yara.Gudunmawar abubuwan muhalli da alama suna canzawa tare da shekarun yara, kamar yadda babban binciken da aka yi a baya game da yara masu shekaru 11-12 ya ba da rahoton wata muhimmiyar ƙungiya tsakanin aikin jijiyoyin yara da IVH.12
Lokacin aikawa: Yuli-14-2021