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Hukama huri pakati pehutano hwakanaka hwemoyo uye vascular phenotype yeamai vakafutisa nevana vavo vane makore matanhatu
Vanyori: 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 Sarkola1,31Children's Hospital, University of Yunivhesiti yeHelsinki neHelsinki University Hospitals, Helsinki, Finland;2 Dhipatimendi reCongenital Heart Defects uye Pediatric Cardiology, Silesian Medical University, Katowice, Poland, Zabrze FMS;3 Minerva Foundation Medical Research Institute, Helsinki, Finland;4 Dhipatimendi reChikafu neChikafu, University of Helsinki, Helsinki, Finland;5LIKES Sports Activity uye Health Research Center, Jyvaskyla, Finland;6 University of Helsinki Women's Hospital uye Helsinki University Hospital muHelsinki, Finland;7 Folkhälsan Research Center, Helsinki, Finland;8 Yunivhesiti yeHelsinki neHelsinki Dhipatimendi reGeneral Practice uye Primary Health Care, University Hospital, Helsinki, Finland;9 Human Potential Transformation Research Program uye Dhipatimendi reObstetrics uye Gynecology, Yang Luling School of Medicine, National University of Singapore, Singapore;10 Singapore Institute of Clinical Sayenzi (SICS), Sayenzi, Technology uye Research Bureau (A* STAR), Singapore Kukurukurirana: Linda Litwin Dhipatimendi reCongenital Heart Defects uye Pediatric Cardiology, Zabrze FMS, Silesian Medical University, M.Sklodowskiej-Curie 9, Zabrze, 41-800, Poland Tel +48 322713401 Fax +48 322713401 Email [email protected] Background: Genetics uye mararamiro emhuri anogona kukonzera njodzi yemwoyo, asi chiyero chaanokanganisa chimiro uye kushanda kwetsinga muhuduku. zvisina kujeka.Isu tine chinangwa chekuongorora kushamwaridzana pakati pehutano hwakanaka hwemwoyo muvana naamai, maternal subclinical atherosclerosis, uye arterial phenotypes muvana.Nzira: Kubva kuFinnish Gestational Diabetes Prevention Study (RADIEL) longitudinal cohort, ongororo yakaitwa yevana 201 vana amai-mwana pamakore 6.1 ± 0.5 yemakore yakaongororwa hutano hwakanaka hwemwoyo (BMI, BP, kutsanya kweglucose yeropa, cholesterol yakazara, mhando yekudya, Kuita kwemuviri, kuputa), kuumbwa kwemuviri, carotid Ultra-yakakwirira frequency ultrasound (25 uye 35 MHz) uye pulse wave velocity.Migumisiro: Takaona kuti pakanga pasina kuwirirana pakati pehutano hwakanaka hwemwoyo yemwana naamai, asi yakashuma humbowo hwekubatana kwezviratidzo zvakananga: cholesterol yose (r = 0.24, P = 0.003), BMI (r = 0.17, P =0.02), Diastolic blood pressure (r=0.15, P=0.03) uye mhando yezvokudya (r=0.22, P=0.002).The pediatric arterial phenotype haina chekuita nehutano hwakanaka hwemoyo wemwana kana amai.Mune multivariate regression modhi yekududzira yakagadziridzwa kune yevana gender, zera, systolic blood pressure, kuonda kwemuviri, uye muviri muzana mafuta, ukobvu hweiyo carotid artery intima-media muvana yaingove yakabatana yakazvimiririra nehupamhi hwematernal carotid artery intima. -media (kuwedzera kwe0.1 mm [95 %] CI 0.05, 0.21, P=0.001] Ukobvu hwematernal carotid artery intima-media yakawedzera ne 1 mm).Vana vaamai vane subclinical atherosclerosis yakaderera carotid artery dilatation (1.1 ± 0.2 vs 1.2 ± 0.2%/10 mmHg, P=0.01) uye yakawedzera carotid artery intima-media ukobvu (0.37 ± 0.04 vs 0.35) ± 0.04 mm) ± 0.04 mm) Mhedziso: Zviratidzo zvehutano hwemoyo zvakafanira zvine hukama hwakasiyana-siyana kune amai-mwana vaviri vaviri muhuduku.Hatina kuwana humbowo hwekuita kwehutano hwakanaka hwemwoyo hwevana kana hwaamai pavana arterial phenotypes.Maternal carotid artery intima-media ukobvu inogona kufanotaura carotid artery intima-media ukobvu muvana, asi maitiro ayo ari pasi haasati ajeka.Maternal subclinical atherosclerosis inoenderana nekuoma kwecarotid artery muhuduku.Keywords: chirwere chemoyo, atherosclerosis, carotid artery intima-media ukobvu, njodzi zvinhu, vana
Chinyakare chemoyo njodzi njodzi zvinhu zvinokonzeresa kuitika uye kukura kweatherosclerosis.1,2 Njodzi dzinowanzobatana pamwe chete, uye kusanganiswa kwavo kunoratidzika kunge kunonyanya kufanotaura nezvehutano hwemwoyo.3
IAmerican Heart Association inotsanangura hutano hwakanaka hwemwoyo (ICVH) seti yezviratidzo zvinomwe zvehutano (body mass index (BMI), blood pressure (BP), kutsanya kweglucose yeropa, cholesterol yakazara, hutano hwekudya, kuita basa remuviri, kusvuta) kukurudzira chinyakare. kudzivirira Chirwere chemwoyo muvana nevakuru.4 ICVH yakabatana zvisina kunaka ne subclinical atherosclerosis mukukura.5 ICVH uye yakaipa vascular phenotypes inovimbika kufungidzira kwezviitiko zvemoyo uye kufa kwevanhu vakuru.6-8
Chirwere chemwoyo chevabereki chinowedzera njodzi yezviitiko zvemoyo mumwana.9 Zvinhu zvakatipoteredza zvine chokuita nemajini uye mararamiro akajairika zvose zvinoonekwa sezvingaita nzira, asi mupiro wavo hausati wasarudzwa.10,11
Kuwirirana pakati pemubereki nemwana ICVH kwatova kuoneka muvana vane makore 11-12 okuberekwa.Panguva ino, ICVH yevana ine hukama ne carotid artery elasticity uye yakashata ine chekuita necervical femoral pulse wave velocity (PWV), asi hairatidzirwe mu carotid artery intima-media ukobvu (IMT).12 Zvisinei, njodzi yemwoyo pakati pemakore 12-18 yezera inosanganiswa nekuwedzera kwecarotid IMT muhupenyu hwepakati-kati, uye haina chokuita nezvinhu zvinokanganisa panguva imwe chete.13 Uchapupu hune chokuita nokusimba kwesonganiro idzi muuduku hunoshaikwa.
Mubasa redu rekare, hatina kuwana migumisiro ye gestational chirwere cheshuga kana kupindira kwehupenyu hweamai pauduku hwekutanga anthropometry, kuumbwa kwemuviri kana arterial size uye basa.14 Chinangwa chekuongorora uku ndiko kuyambuka-chizvarwa chemaitiro ehutano hwehutano hwemwoyo.Kirasi uye maitiro ayo pane arterial phenotype yevana.Isu tinofungidzira kuti maternal ICVH uye vascular substitutes for cardiovascular disease icharatidzwa muhuduku ICVH uye arterial phenotypes muhuduku hwepakutanga.
Iyo yakayambuka-chikamu data kubva mukutevera-makore matanhatu eFinnish Gestational Diabetes Prevention Study (RADIEL).Yekutanga dhizaini yekutsvagisa yakatsanangurwa kumwe kunhu.15 Muchidimbu, vakadzi vanoronga kuva nepamuviri kana kuti vari muhafu yekutanga yepamuviri uye vane ngozi yakawanda ye gestational diabetes (kufutisa uye / kana nhoroondo ye gestational chirwere cheshuga) vakanyorerwa (N = 728).Iyo 6-gore yemoyo yemoyo yekutevera yakagadziridzwa seyekutarisa yekuongorora yaamai-vacheche vaviri vaviri, nenhamba yakaenzana yevanaamai vane uye vasina gestational chirwere cheshuga, vane hukuru hwakatarwa hweboka (~ 200).Kubva munaChikumi 2015 kusvika Chivabvu 2017, kukoka kunoenderera kwakatumirwa kune vatori vechikamu kudzamara muganhu wasvika, uye 201 pairs of two-tuples vakatorwa.Kutevera kwakagadzirirwa vana vane makore 5-6 emakore kuti vave nechokwadi chekushandira pamwe pasina sedation, kusanganisira amai-mucheche mabhinari eboka rekuongorora kwehukuru hwemuviri uye kuumbwa, BP, kutsanya kweglucose yeropa uye lipids yeropa, kushanda kwemuviri uchishandisa accelerometers, unhu hwekudya uye kusvuta mibvunzo (vanaamai), midziyo yeropa Ultrasound uye intraocular pressure measurement uye echocardiography muvana.Kuwanikwa kwedata kwakanyorwa muSupplementary Tafura S1.Dare reEthics of Obstetrics uye Gynecology, Pediatrics uye Psychiatry yeHelsinki University Hospital yakabvumira chirongwa chekutsvakurudza (20/13/03/03/2015) yemakore matanhatu ekutevera kuongororwa.Rubvumo yakanyorwa neruzivo rwaamai vese yakawanikwa panguva yekunyoreswa.Chidzidzo chacho chakaitwa maererano neDeclaration of Helsinki.
Muongorori ane hunyanzvi (TS) anoshandisa 25 MHz uye 35 MHz matransducer ane Vevo 770 system, uye anoshandisa UHF22, UHF48 (yakafanana centre frequency) uye Vevo MD system (VisualSonics, Toronto, Canada) seyekupedzisira makumi mashanu nemaviri mapaya aamai nemwana.Iyo yakajairwa carotid artery yakafananidzirwa 1 cm proximal kune bilateral carotid bulbs, uye nzvimbo yekuzorora yaive munzvimbo yekumusoro.Shandisa iyo yepamusoro frequency inogona kuona madziro ari kure kuti uwane emhando yepamusoro firimu mifananidzo inovhara 3-4 moyo kutenderera.Shandisa Vevo 3.0.0 (Vevo 770) ine manual electronic calipers uye VevoLab (Vevo MD) software kuongorora mifananidzo pasina Indaneti.16 Lumen dhayamita uye IMT yakayerwa nemucherechedzi ane ruzivo (JKMS) pamagumo ediastole achishandisa nzira dzekucheka-kumucheto), asingazivi nezvezvinyorwa zvezvidzidzo (Supplementary Figure S1).Takambotaura kuti intra-observer coefficient of variation yakayerwa ne-ultra-high-resolution ultrasound muvana nevakuru ndeye 1.2-3.7% mudhayamita ye lumen, IMT ndeye 6.9-9.8%, uye inter-observer coefficient of variation ndeye. 1.5-4.6% muhuwandu hwe lumen., 6.0-10.4% yeIMT.Iyo carotid IMT Z mamakisi akagadziridzwa zera uye murume kana mukadzi akaverengerwa pachishandiswa referensi yevachena vane hutano vasiri vana vakafuta.17
Carotid artery lumen diameter yakayerwa pa peak systole uye end-diastole kuti iongorore carotid artery β stiffness index uye carotid artery yekuwedzera coefficient.Uchishandisa cuff yakaenzana yakaenzana, nzira ye oscillometric (Dinamap ProCare 200, GE) yakashandiswa kunyora systolic uye diastolic blood pressure ye elastic performance calculations panguva ye ultrasound imaging in the supine position yeruoko rworudyi.Iyo carotid artery yekuwedzera coefficient uye iyo carotid arteri β-kuoma indekisi inoverengerwa kubva mutsinga yecarotid uchishandisa formula inotevera:
Pakati pavo, CCALAS neCCALAD ndiyo inowanzonzi carotid artery lumen area panguva ye systole uye diastole maererano;CCALDS uye CCALDD ndiyo yakajairika carotid artery lumen dhayamita panguva yesystole uye diastole zvakateerana;SBP uye DBP ndeye systolic uye diastolic blood pressure.18 Chiyero chekusiyana kweiyo carotid artery yekuwedzera coefficient mucherechedzi ndeye 5.4%, iyo inofananidzwa yekusiyana kweiyo carotid arteri β stiffness index ndeye 5.9%, uye ye-inter-observer coefficient yekusiyana kweiyo carotid artery yekuwedzera ndeye 11.9% coefficient uye 12.8% ye carotid artery β stiffness index.
Iyo yechinyakare yakakwirira-resolution Ultrasound Vivid 7 (GE) ine 12 MHz mutsara transducer yakashandiswa kuenderera mberi nekuona iyo yaamai carotid artery yeplaque.Kutanga kubva kune yakajairika carotid artery padyo negirobhu, iyo carotid artery inoongororwa bifurcation uye proximal chikamu chemukati nekunze carotid arteries.Maererano nekubvumirana kweMannheim, plaque inotsanangurwa se 1. Kuwedzera kwenzvimbo yemadziro emudziyo ne 0.5 mm kana 50% yeIMT yakapoteredza kana 2. Iyo yakazara arterial wall thickness inodarika 1.5 mm.19 Kuvapo kweplaque kwakaongororwa nedichotomy.Mucherechedzi wekutanga (JKMS) anozvimiririra anoita zviyero zvakadzokororwa pane subset yemifananidzo (N = 40) kuti aongorore kushanduka kwemukati-mucherechedzi, uye wechipiri mucherechedzi (TS) anoongorora kusiyana kwe-inter-observer.The Cohen κ ye intra-observer variability uye inter-observer variability yaiva 0.89 uye 0.83, maererano.
PWV yakayerwa nana mukoti akadzidzira tsvakiridzo kuti aongorore kuomarara kwetsinga yedunhu achishandisa mechanical sensor (Complior Analyse, Alam Medical, Saint-Quentin-Fallavier, France) apo akazorora ari supine position.20 Masensor anoiswa parudyi carotid artery, right radial artery, and right femoral artery kuongorora nechepakati (right carotid artery-femoral artery) and peripheral (right carotid artery-radial artery) transit time.Shandisa tepi chiyero kuyera nhambwe yakananga pakati penzvimbo dzekurekodha kusvika padyo 0.1 cm.Iyo yekurudyi yecarotid femoral artery kureba inopetwa ne0.8 uye yobva yashandiswa pakati pePWV kuverenga.Dzokorora kurekodha munzvimbo ye supine.Zvinyorwa zviviri zvakawanikwa apo rekodhi yechitatu yakaitwa munzvimbo iyo musiyano pakati pezviyero waiva mukuru kudarika 0.5 m / s (10%).Mukugadzirisa kwezviyero zvinopfuura zviviri, chigumisiro chine kushivirira kwakaderera kunoshandiswa pakuongorora.Kushivirira imhando yeparameter inoverengera kusiyanisa kwe pulse wave panguva yekurekodha.Shandisa avhareji yezviyero zviviri mukuongorora kwekupedzisira.Iyo PWV yevana 168 inogona kuyerwa.Iyo coefficient yekusiyana kwezviyero zvakadzokororwa yaive 3.5% yecarotid-femoral artery PWV uye 4.8% yecarotid-radial artery PWV (N = 55).
Seti yezvitatu zvebhinari zviratidzo zvinoshandiswa kuratidza amai subclinical atherosclerosis: kuvepo kwecarotid artery plaque, carotid artery IMT yakagadziridzwa zera uye inodarika 90th percentile mumuenzaniso wedu, uye inopfuura 90 muzana PWV yemutsipa nefemur inofananidzwa. nezera uye BP yakakwana.makumi maviri nerimwe
ICVH iri seti ye7 mabhinari zviratidzo ane cumulative renji kubva 0 kusvika 7 (iyo yakakwira mamakisi, zvakanyanya kuenderana nemirairo).4 ICVH zviratidzo zvinoshandiswa muchidzidzo ichi zvinopindirana netsanangudzo yepakutanga (kugadziriswa katatu kwakaitwa) -Supplementary Table S2) uye inosanganisira:
Hunhu hwekudya hunoongororwa neFinnish Child Healthy Eating Index yemwana (range 1-42) uye indekisi yekudya ine hutano yaamai (range 0-17).Zvose zvinyorwa zvinovhara 4 yezvikamu zve5 zvakabatanidzwa muchiratidzo chekudya chepakutanga (kunze kwekudya kwe sodium).23,24 Kukosha kwakakosha kwehutano hwakanaka uye husina kunaka hwekudya hunotsanangurwa se60% kana kupfuura kuratidza hutano hwekudya kwepakutanga.Tsanangudzo yechiratidzo (yakanaka kana kupfuura 3 ye5 maitiro asangana).Tichitaura nezvevachangoburwa vane hutano hwevana vevana vekuFinnish (87.7% yevasikana, 78.2% yevakomana), kana mupimo wakanangana nevakadzi vevana vakafuta ukapfuura, BMI yemwana inotsanangurwa seisina kunaka, iyo yakasiyana zvishoma ne85. % yehuwandu hweFinland.22 Nekuda kwenhamba huru yevasiira chikoro panzira uye kusarura kwakanyanya kwakaderera (Supplementary Table S1, 96% yevanaamai vanosangana neICVH maitiro), kuita basa remuviri revakadzi vane pamuviri uye vakarara-mune vakadzi rakabviswa.ICVH yakakamurwa muzvikamu zvinotevera: yakaderera (vana 0-3, vanaamai 0-2), yepakati (vana 4, vanaamai 3-4) uye yakakwirira (vana naamai 5-6), ichipa mukana wekuenzanisa zvikamu zvakasiyana. .
Shandisa midziyo yemagetsi (Seca GmbH & Co. KG, Germany) kuyera urefu nehuremu kune iri pedyo 0.1 cm uye 0.1 kg.Zvibodzwa zveBMI Z zvevana zvinogadzirwa zvichitariswa kune ichangoburwa yeFinnish yehuwandu data set.22 Kuumbwa kwemuviri kwakapfuura bioelectrical impedance assessment (InBody 720, InBody Bldg, South Korea).
Kuzorora kweropa kwakayerwa nenzira ye oscillometric kubva kuruoko rworudyi munzvimbo yakagara (Omron M6W, Omron Healthcare Europe BV, The Netherlands) ine cuff yakakwana.Avhareji systolic uye diastolic blood pressure inoverengwa kubva pazviyero zviviri zvakaderera (zvishoma zviyero zvitatu).Kukosha kweropa revana Z kunoverengerwa zvinoenderana negwara.25
Ropa sampuli dzeplasma glucose uye lipids dzakaunganidzwa pasi pemamiriro ekutsanya.Zvigumisiro kubva kuvana ve3 vane kusava nechokwadi kwekuteerera kwekutsanya (yakawandisa high triglycerides, kutsanya ropa glucose, uye glycosylated hemoglobin A1c (HbA1c)) yakabviswa kubva pakuongorora.Cholesterol yose, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol uye triglycerides inotarwa nemaitiro enzymatic, plasma glucose uye enzymatic hexokinase determination, uye HbA1c uye immunoturbidimetric analyzer (Roche Diagnostics, Basel, Switzerland) yekuongorora .
Kudya kwaamai kwekudya kwakaongororwa nemibvunzo yehuwandu hwezvokudya uye zvakare kuongororwa nendekisi yezvokudya zvine utano.Iyo Healthy Food Intake Index yakave yakasimbiswa sechishandiso chinobatsira kuratidza kutevedzera Nordic Nutrition Recommendation 26 mune yekutanga RADIEL cohort.24 Muchidimbu, ine zvinhu gumi nechimwe chete, zvinofukidza kudyiwa kwemuriwo, michero uye michero, zviyo zvine fiber yakawanda, hove, mukaka, chizi, mafuta ekubikisa, masosi ane mafuta, snacks, zvinwiwa zvine shuga uye chikafu chinokurumidza.Iyo yakakwirira yezvibodzwa inoratidza yakakwirira dhigirii yekutevedzera zvinokurudzirwa.Unhu hwekudya kwevana hwakaongororwa kuburikidza ne3-day zvinyorwa zvekudya uye zvakare kuongororwa neFinnish Children's Healthy Eating Index.Iyo Finnish Vana Yehutano Hwekudya Index yakave yakasimbiswa muhuwandu hwevana veFinland.23 Zvinosanganisira marudzi mashanu ezvokudya: miriwo, michero uye michero;mafuta uye margarine;zvokudya zvine shuga yakawanda;hove nehove nemiriwo;uye mukaka wakanyungudutswa.Kudyiwa kwechikafu kunowanikwa kuitira kuti iyo yakanyanya kudyiwa, iwedzere zvibodzwa.Kunze kwezvikafu zvine shuga yakawanda, chiyero chinodzoserwa kumashure.Usati watora, gadzirisa simba rekutora nekuparadzanisa kutora (magiramu) nekutora simba (kcal).Iyo yakakwirira yezvibodzwa, zviri nani kunaka kwekudya kwevana.
Kurovedzera muviri kuri pakati nepakati kusvika kune kwakasimba (MVPA) kwakayerwa pachishandiswa mwana hip accelerometer (ActiGraph GT3X, ActiGraph, Pensacola, USA) uye bhande remaoko raamai (SenseWear ArmBand Pro 3).Yakarairwa kupfeka cheki panguva yekumuka uye yekurara, asi nguva yekurara yakabviswa kubva pakuongorora.Mucherechedzo wemwana anounganidza data pamwero wesampling we30 Hz.Iyo data inowanzosefa, ichishandurwa kuita gumi-yechipiri epoch kuverenga, uye kuongororwa uchishandisa Evenson (2008) cut point (≥2296 cpm).27 Mai yekutarisa inounganidza MET kukosha mune makumi matanhatu-sekondi epoch.MVPA inoverengwa seMET inokosha inopfuura 3. Kuyera kunobudirira kunotsanangurwa semazuva ekushanda kwe2 uye 1 vhiki yevhiki (kurekodha zvishoma nemaminitsi e480 pazuva) uye 3 mazuva ekushanda uye 1 vhiki yevhiki (kurekodha zvishoma nemaminitsi 720 pazuva) amai.MVPA nguva inoverengwa seavhareji yakayerwa [(avhareji MVPA maminetsi/zuva pamazuva evhiki × 5 + avhareji MVPA maminetsi/zuva pakupera kwevhiki × 2)/7], mukuwedzera, sechikamu chezana chenguva yekupfeka.Iyo yazvino data yechiitiko chemuviri chevanhu vekuFinnish yakashandiswa sereferensi.28
Bhuku remibvunzo rakashandiswa kuwana ruzivo pamusoro pekusvuta kwaamai, zvirwere zvisingaperi, mishonga, uye dzidzo.
Dhata dzinoratidzwa sezvinoreva ± SD, yepakati (interquartile renji) kana kuverenga (muzana).Ongorora kugoverwa kwakajairwa kwese kuenderera kuchinjika zvichienderana nehistogram uye yakajairika QQ plot.
Yakazvimirira sampuli t bvunzo, Mann-Whitney U bvunzo, imwe-nzira yekuongorora yekusiyana, Kruskal-Wallis, uye chi-square bvunzo yakashandiswa sezvakakodzera kumapoka ekuenzanisa (amai nemwana, mukomana nemusikana, kana yakaderera uye yepakati uye yakakwirira ICVH. )
Iyo Pearson kana Spearman chinzvimbo chekubatanidza coefficient yakashandiswa kuongorora univariate kushamwaridzana pakati pehunhu hwemwana naamai.
Iyo multivariate linear regression modhi yakashandiswa kumisikidza inotsanangura modhi yevana HDL cholesterol uye carotid IMT.Kusarudzika kusarudzwa kwakavakirwa pakubatana uye nyanzvi yekutonga kwekiriniki, inodzivirira yakakosha multicollinearity mumuenzaniso, uye inosanganisira zvinogona kuvhiringidza zvinhu.Multicollinearity inoongororwa uchishandisa musiyano weinflation factor, ine huwandu hunokosha hwe1.9.Multivariate linear regression yakashandiswa kuongorora kupindirana.
Maviri-muswe P ≤ 0.05 akaiswa kuti ave akakosha, kunze kwekuenderana nekuongororwa kwezvinotsanangurwa zvecarotid artery IMT muvana vane P ≤ 0.01.
Maitiro evatori vechikamu anoratidzwa muTafura 1 uye Supplementary Tafura S3.Zvichienzaniswa nehuwandu hwereferensi, nhamba yevana BMI Z uye BP Z yakawedzera.Basa redu rekare rakarondedzera ruzivo rwakadzama pamusoro pe arterial morphology muvana.14 Chete 15 (12%) vana uye 5 (2.7%) vanaamai vakasangana neyese ICVH maitiro (Supplementary Figures 2 uye 3, Supplementary Tables S4-S6).
Mucherechedzo weICVH waamai nemucheche unongoenderana nevakomana (vakomana: rs=0.32, P=0.01; vasikana: rs=-0.18, P=0.2).Kana ichiongororwa sechinhu chinoramba chichienderera mberi, iyo yaamai-mucheche univariate correlation analysis ine kukosha kukuru mukuyera kweropa lipids, HbA1C, kufuta, diastolic blood pressure, uye kudya kwehutano (Supplementary Figures S4-S10).
LDL, HDL yavana naamai, uye cholesterol yose zvakabatana (r=0.23, P=0.003; r=0.35, P<0.0001; r=0.24, P=0.003, Mufananidzo 1).Pazvikarongwa maererano nehukadzi hwemwana, kuwirirana pakati peLDL yemwana naamai uye cholesterol yese yakaramba ichikosha kuvakomana (Supplementary Table S7).Triglycerides uye HDL cholesterol yakabatana nemafuta emuviri wevasikana muzana (rs = 0.34, P = 0.004; r = -0.37, P = 0.002, zvichienderana, Mufananidzo 1, Supplementary Table S8).
Mufananidzo 1 Hukama huripo pakati pemwana naamai ropa lipids.Kuparadzira chirongwa chine mutsara wekudzoreredza mutsara (95% nguva yekuvimba);(AC) mazinga eropa remamai uye emucheche;(D) chikamu chemafuta emuviri wemusikana uye high-density lipoprotein cholesterol.Mibairo yakakosha inoratidzwa nemavara matema (P ≤ 0.05).
Kupfupisa: LDL, pasi-density lipoprotein;HDL, high-density lipoprotein;r, Pearson coefficient yekubatanidza.
Takaona kuti pane kuwirirana kwakakosha pakati peHbA1C yemwana naamai (r = 0.27, P = 0.004), asi yakanga isingabatanidzi nekutsanya kweglucose yeropa (P = 0.4).Chibodzwa chevana cheBMI Z, asi kwete chikamu chemafuta emuviri, chine hukama neBMI yaamai uye chiuno-ku-hip reshiyo (r=0.17, P=0.02; r=0.18, P=0.02, zvichiteerana).Kukosha kweZ kwevana diastolic blood pressure haina kusimba yakabatana nediastolic blood pressure yaamai (r=0.15, P=0.03).Indekisi yekudya kune hutano kwevana veFinnish inodyidzana neindex yaamai yekudya kune hutano (r=0.22, P 0.002).Hukama uhwu hwaingoonekwa muvakomana (r=0.31, P=0.001).
Pashure pokubvisa vanaamai vairapwa hypertension, hypercholesterolemia, kana hyperglycemia, migumisiro yacho yakanga yakafanana.
Iyo yakadzama arterial phenotype inoratidzwa muSupplementary Tafura S9.Iro vascular structure yevana yakasununguka kune maitiro evana (Supplementary Table S10).Hatina kucherechedza chero kushamwaridzana pakati pehuduku ICVH uye vascular structure kana basa.Mukuongorora kwevana vakarongwa neICVH zvibodzwa, takaona kuti carotid IMT Z zvibodzwa zvevana vane zvibodzwa zvine mwero chete zvakawedzera zvichienzaniswa nevana vane zvibodzwa zvakaderera (zvinoreva ± SD; zvibodzwa zvine mwero 0.41 ± 0.63 vs low low- 0.07 ± 0.71, P = 0.03, Supplementary Table S11).
Maternal ICVH haibatanidzi nevascular phenotype yevana (Supplementary Tables S10 uye S12).Vana uye maternal carotid artery IMT yakabatana (Mufananidzo 2), asi kuwirirana kweamai nemwana pakati pezvakasiyana-siyana zvekuoma kwetsinga hazvina kukosha (Supplementary Table 9, Supplementary Figure S11).Mune multivariate regression dudziro modhi yakagadziridzwa yevana murume kana mukadzi, zera, systolic blood pressure, kuonda kwemuviri, uye muviri muzana muzana, maternal carotid IMT ndiyo yega yakazvimiririra inofanotaura yevana carotid IMT (yakagadziridzwa R2 = 0.08).Kune yega yega 1 mm kuwedzera kweMaternal carotid IMT, yehudiki carotid IMT yakawedzera ne0.1 mm (95% CI 0.05, 0.21, P = 0.001) (Supplementary Table S13).Gender yemwana haina kuderedza izvi.
Mufananidzo 2 Kuwirirana pakati pecarotid artery intima-media ukobvu muvana naamai.Kuparadzira chirongwa chine mutsara wekudzoreredza mutsara (95% nguva yekuvimba);(A) carotid yaamai nemwana IMT, (B) carotid yaamai IMT percentile uye mwana carotid IMT z-score.Mibairo yakakosha inoratidzwa nemavara matema (P ≤ 0.05).
Chiyero chemuviri weropa remadzimai chinopindirana nekarotid artery yekuwedzera coefficient uye β kuoma index muvana (rs = -0.21, P = 0.007, rs = 0.16, P = 0.04, Supplementary Table S10, maererano).Vana vanozvarwa naamai vane vascular score ye1-3 vane yakaderera coefficient ye carotid artery kuwedzera pane avo vanozvarwa naamai vane zvibodzwa zve0 (zvinoreva ± standard kutsauka, 1.1 ± 0.2 vs 1.2 ± 0.2%/10 mmHg, P= 0.01) uye pane tsika yekuwedzera carotid artery β stiffness index (median (IQR), 3.0 (0.7) uye 2.8 (0.7), P = 0.052) uye carotid artery IMT (kureva ± SD, 0.37 ± 0.04 ± 0.04 ± 0.04 uye 0.3 mm, P = 0.06) (Mufananidzo 3), Supplementary Table S14).
Mufananidzo 3 Mwana vascular phenotype yakarongedzwa nematernal vascular score.Dhata dzinoratidzwa sezvinoreva + SD, P ine yakazvimirira sampuli t bvunzo (A uye C) uye Mann-Whitney U bvunzo (B).Mibairo yakakosha inoratidzwa nemavara matema (P ≤ 0.05).Chikero chetsinga yeropa yaamai: renji 0-3, seti yezvitatu zvebhinari zviratidzo: kuvepo kwecarotid plaque, ukobvu hwecarotid artery intima-media yakagadziriswa nezera uye yakapfuura 90% mumuenzaniso wedu, uye cervical-femoral pulse wave. velocity inodarika 90% inoenderana nezera uye yakakwana yeropa.makumi maviri nerimwe
Nhamba yemadzimai (ICVH, vascular score) uye kusanganiswa kwevana uye zvikwereti zvemamai hazvibatanidzi arterial phenotype yevana (Supplementary Table S10).
Mukuongorora kwechikamu-chikamu chevanaamai nevana vavo vane makore matanhatu, takaongorora hukama pakati pehucheche ICVH, ICVH yaamai, uye maternal subclinical atherosclerosis ine chimiro uye kushanda kwetsinga dzevana.Chinonyanya kuwanikwa ndechokuti amai chete subclinical atherosclerosis, nepo vana uye amai kwakajairika mwoyo ngozi zvinhu hazvina chokuita kwakaipa kuchinja muuduku vascular phenotypes.Iyi nzwisiso nyowani mukukura kwevascula yevadiki inowedzera kunzwisisa kwedu kweiyo intergenerational maitiro e subclinical atherosclerosis.
Isu tinoshuma humbowo hwekudzikira kwecarotid artery dilatation uye maitiro mucarotid artery beta kuomarara uye carotid artery IMT muvana vevanaamai vane chirwere chemoyo vascular chinotsiva.Zvisinei, hapana kuwirirana kwakananga pakati pemamai uye mucheche vascular function zviratidzo.Isu tinofungidzira kuti kusanganisira plaque yaamai mukati mevascular score zvakanyanya inowedzera kukosha kwayo kwekufungidzira.
Takacherechedza kuwirirana kwakanaka pakati pe carotid artery IMT muvana naamai;zvisinei, iyo nzira haisati yanyatsojeka nokuti iyo carotid artery IMT muvana yakasununguka kubva kune unhu hwemwana uye amai.Kudyidzana pakati pezvibodzwa zveICVH zvevana necarotid IMT kwakaratidza kusaenderana, nekuti hatina kuona musiyano uripo pakati peICVH yakaderera neICVH yakakwirira.
Tinoziva kuti zvimwe zvinhu zvinogona kuita basa, kusanganisira denderedzwa remusoro wevana, izvo zvingave zvakakosha kufanotaura kwekukura kwetsinga ye carotid mumatanho ekutanga ekukura.Mukuwedzera, migumisiro yedu inogona kunge yakakonzerwa nezvinhu zvisingaenzaniswi zvinokanganisa kukura kwe fetus.Nekudaro, isu takambotaura kuti pre-pamuviri kuwandisa / kufutisa uye gestational chirwere cheshuga hazvina chazvinoita paudiki carotid IMT.14 Imwe tsvakiridzo inodiwa kuti uongorore pesvedzero ye arterial chimiro uye kushanda pakukura kwevana uye genetic background.
Masangano akashumwa anowirirana nezvidzidzo zvekare zvakaitwa muvechiri kuyaruka, izvo zvakapa uchapupu hwekubatana pakati pevabereki-mwana vascular phenotypes, kusanganisira carotid IMT, kunyange zvazvo ukuru hwemuviri husina kugadziriswa pakuongorora.29 Kuwanda kwenhaka yecarotid IMT inosimbisazve izvi uye kuomarara kwetsinga dzevakuru.30,31
Kubatana kwakacherechedzwa pakati peamai subclinical atherosclerosis uye yehucheche vascular phenotype haina kuwedzerwa naamai ICVH.Izvi zvinopindirana nezvidzidzo zvekare umo chikamu chikuru chekusiyana kwevana vascular phenotype inotsanangurwa nemararamiro emagetsi akazvimirira pane zvakajairwa zvemoyo zvengozi yevabereki nevana.29
Mukuwedzera, iyo yakacherechedzwa shanduko yevascular haina chekuita nehudiki ICVH, zvichiratidza pesvedzero huru yepakutanga genetic background.Mupiro wezvinhu zvakatipoteredza unoratidzika kuchinja nezera revana, sezvo yapfuura yakakura-chikamu chechikamu chekuongorora chevana vane makore 11-12 yakashuma kushamwaridzana kwakakosha pakati pevana vevascular function uye ICVH.12
Nguva yekutumira: Jul-14-2021