Childhood CV Risk and Adult CVD Outcomes: an International Long-term Follow-up

儿童心血管风险和成人心血管疾病结果：国际长期随访

• 批准号: 8818169
• 负责人: TRUDY L BURNS
• 金额: $ 284.25万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2019-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8818169
• 关键词: Address; Adolescence; Adolescent; Adult; Adverse effects; Age; Aneurysm; Angina Pectoris; Australia; Blood Pressure; Cardiovascular system; Cause of Death; Cessation of life; Child; Childhood; Cholesterol; Clinic; Clinical Research; Cohort Studies; Collaborations; Coronary heart disease; Data; Development; Diabetes Mellitus; Disease; Enrollment; Ethnic Origin; Event; Finland; Funding; Growth; Health; Heart; Heart Diseases; Heart failure; High Density Lipoprotein Cholesterol; Incidence; Individual; International; Intervention; Iowa; Joints; LDL Cholesterol Lipoproteins; Life; Link; Lipids; Longitudinal Studies; Louisiana; Measurement; Measures; Medical Records; Meta-Analysis; Minnesota; Morbidity - disease rate; Myocardial Infarction; National Heart, Lung, and Blood Institute; Nature; Ohio; Outcome; Participant; Patient Self-Report; Peripheral arterial disease; Preventive; Publications; Publishing; Questionnaires; Race; Research; Research Proposals; Risk; Risk Factors; Risk Reduction; Sample Size; Stroke; Structure; Time; Transient Ischemic Attack; Triglycerides; United States National Institutes of Health; Weight; adjudicate; adjudication; cardiovascular risk factor; cohort; data sharing; design; follow-up; indexing; innovation; insight; meetings; member; mortality; novel; public health relevance; response; sex

DESCRIPTION (provided by applicant): The primary objective of this research proposal is to determine the nature of relationships between levels of cardiovascular (CV) risk factors (anthropometrics, lipids, blood pressure) in childhood and CV morbidity and mortality in adulthood. The NHLBI Pediatric CV Risk Reduction Initiative noted that the lack of longitudinal studies linking CV risk factor levels in children to CV endpoints in adulthood is a major clinical research gap that needs to be spanned. This research will close that gap by pooling data on participants from seven major U.S. and international longitudinal cohort studies that were initiated in the 1970s and 1980s. These studies all have measured detailed CV risk factors in childhood, and have follow-up data spanning childhood and adulthood. They have been collaborating since 2009 as the International Childhood Cardiovascular Cohort (i3C) Consortium, with an administrative organization, regular organizational and data sharing meetings, and fifteen joint publications. Specific Aim 1 of this study is to locate the childhood participants of five NIH-funded longitudinal studies in the U.S. (BHS, MUSC, PFS, MCCS, and NGHS) and two international studies (YFS and CDAH); identify incident CV endpoints (coronary heart disease, myocardial infarction, heart failure, peripheral artery disease, and stroke) using self-reported morbidity validated by adjudication of medical records; and identify decedents using the National Death Index and adjudicate cause of death for deceased participants. In Aim 2, these data will be used to address the hypotheses that: 1) Adverse childhood/adolescent (age 3-19) CV risk factor levels (BMI, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, BP) are related to increased incidence of CV endpoints in adulthood.; 2) A CV risk score weighting childhood/adolescent risk factors (BMI, BP, lipids, age, sex and race/ethnicity) is a stronger predictor of adult CV endpoints than any individual risk factor.; and 3) The relationship of individual risk factors or CV risk score with adult CV endpoints becomes stronger with increasing age from childhood (age 3-11) to adolescence (age 11-19). Aim 3 will evaluate the association of CV risk score trajectories on adult CV endpoints, focusing on trajectories during childhood/adolescence (hypothesis 4) and between childhood/adolescence and adulthood (hypothesis 5). The present proposal is innovative in that it assembles, for the first time, a cohort of sufficient size (22,883 anticipated recruitment), with childhood risk factor measurements, and with a duration of follow-up (40 years) that will enable follow-up of participants at ages when CV events occur. It will, therefore, provide novel insights into how childhood risk factors contribute to adult cardiometabolic disease.

描述（由申请人提供）：这项研究建议的主要目的是确定儿童期心血管（CV）危险因素（人类学，脂质，血压）之间的关系的性质，成年期的CV发病率和死亡率。 NHLBI儿科简历降低风险降低计划指出，缺乏将儿童中简历风险因素水平与成年后CV终点联系起来的纵向研究是需要跨越的主要临床研究差距。这项研究将通过在1970年代和1980年代启动的美国七项主要和国际纵向队列研究的参与者汇总数据来缩小这一差距。这些研究都测量了儿童期的详细CV风险因素，并具有跨越儿童期和成年的随访数据。自2009年以来，他们一直担任国际童年心血管队列（I3C）财团，由行政组织，常规的组织和数据共享会议以及15个联合出版物。这项研究的具体目的1是在美国（BHS，MUSC，PFS，MCC和NGHS）和两项国际研究（YFS和CDAH）找到五项NIH资助的纵向研究的童年参与者；使用自我报告的发病率通过裁定病历来确定事件CV终点（冠心病，心肌梗死，心力衰竭，周围动脉疾病和中风）；并使用国家死亡指数和已故参与者的死亡原因确定死者。在AIM 2中，这些数据将用于解决以下假设：1）儿童/青少年（3-19岁）CV危险因素水平（BMI，总胆固醇，LDL胆固醇，HDL胆固醇，甘油三酸酯，BP）与Adulthood中CV端点的增加有关。 2）CV风险评分加权儿童/青少年风险因素（BMI，BP，脂质，年龄，性别和种族/种族/种族/种族）比任何个人CV终点的预测指标都比任何个人CV终点。 3）个人风险因素或简历风险评分与成人简历终点的关系变得更强大，随着儿童期（3-11岁）到青春期的增长（11-19岁）。 AIM 3将评估成人CV终点的简历风险评分轨迹的关联，重点是儿童/青春期（假设4）以及儿童/青春期和成年期（假设5）。本提案具有创新性，因为它首次组装了足够大小的队列（22,883份预期招募），以及儿童危险因素测量值，并随着时间的随访时间（40年），可以在CV事件发生时对参与者的年龄进行随访。因此，它将提供有关儿童危险因素如何促进成人心脏代谢疾病的新颖见解。