Childhood Origins for Cardiac Structure and Function

心脏结构和功能的童年起源

• 批准号: 8492156
• 负责人: SHUMEI S SUN
• 金额: $ 63.81万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8492156
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Age; Appearance; Biological Markers; Birth; Blood Pressure; Body Composition; Body Size; Body fat; Cardiac; Centers for Disease Control and Prevention (U.S.); Central obesity; Child; Childhood; Congenital Heart Defects; Consent; Country; Data; Data Set; Derivation procedure; Development; Early identification; Epidemic; Fatty acid glycerol esters; Growth; Height; Hypertension; Individual; Intervention; Lead; Left; Left Ventricular Ejection Fraction; Left Ventricular Mass; Life; Life Style; Longitudinal Studies; Measurement; Measures; Metabolic syndrome; Modeling; Normal Range; Obesity; Participant; Pathologic; Physiological; Population Study; Prevalence; Procedures; Process; Public Health; Relative (related person); Risk; Shortening Fraction; Structure; Thick; Time; Ventricular; age group; base; boys; cationic antimicrobial protein CAP 37; experience; falls; girls; high risk; indexing; normotensive; obesity in children; public health relevance; sex; sexual dimorphism; waist circumference

DESCRIPTION (provided by applicant): The epidemic of childhood obesity that has affected children and adolescents in this country has led to an increased prevalence of hypertension in these age groups. Analyses of the Fels Longitudinal Study (FLS) data set have shown that elevated blood pressure in childhood tracks into adulthood with fidelity and that elevated blood pressure in childhood, even within the range considered to be normal---from the 70th to the 95thpercentiles of the National CDC growth charts (2000)---accurately predict hypertension and the metabolic syndrome in adulthood. In view of the close association of obesity and hypertension and of the association of hypertension with abnormalities of cardiac structure and function, it would be of public health importance to ascertain if childhood obesity predicts abnormalities of cardiac structure and/or function later in life. We are poised to interrogate a portion of the FLS data set to address this question. The pertinent portion of the FLS data set includes serial anthropometric and blood pressure measurements from birth---and body composition measurements from age eight years---through adulthood in 750 participants who consented to undergo echocardiographic studies as adults. Hierarchical and cluster longitudinal modeling procedures will be applied to this unique set of serial measurements to elucidate the relationships between childhood obesity, blood pressure, tempo of maturation, and abnormal cardiac structure and function. The specific aims that we plan to investigate include ascertaining the effects of children's blood pressure, body size, and body composition on (1) blood pressure, (2) cardiac structure, and (3) cardiac function in the same subjects decades later as adults. We have available for analysis more than 750 echocardiographic studies from which to derive the structural measurements of left ventricular mass index (LVMI), interventricular septal thickness (IVST), and relative wall thickness (RWT) and the functional measurements of ejection fraction (EF) and left ventricular shortening fraction (LVSF). These proposed analyses have the potential to quantify risk for hypertension and abnormalities of cardiac structure and function in adulthood given certain values for body size, body composition, and blood pressure in childhood and adolescence, even if these values fall within currently accepted normal values. If we identify biomarkers in children that predict hypertension, and/or abnormal cardiac structure and function in adults, then children with these biomarkers can be evaluated more thoroughly and offered lifestyle and/or pharmacologic interventions before irreversible pathologic changes have occurred. Conversely, our proposed analyses also have the potential to identify a set of ranges of body size, body composition, and blood pressure in childhood and adolescence which are not associated with hypertension or abnormal cardiac structure and function later in life and which can be used to predict a normotensive adulthood, free of cardiac structural or functional abnormalities.

描述（由申请人提供）：儿童肥胖症的流行影响了该国的儿童和青少年，导致这些年龄段的高血压患病率增加。 Fels 纵向研究 (FLS) 数据集的分析表明，儿童时期的血压升高会准确地追踪到成年期，并且儿童时期的血压升高，即使在被认为正常的范围内——从 70% 到 95% 。国家疾病预防控制中心生长图表（2000）——准确预测成年期高血压和代谢综合征。鉴于肥胖和高血压的密切关联以及高血压与心脏结构和功能异常的关联，确定儿童肥胖是否预示着以后生活中的心脏结构和/或功能异常对于公共卫生具有重要意义。我们准备询问 FLS 数据集的一部分来解决这个问题。 FLS 数据集的相关部分包括 750 名同意成年后接受超声心动图研究的参与者从出生开始的连续人体测量和血压测量，以及从 8 岁到成年的身体成分测量。分层和聚类纵向建模程序将应用于这套独特的连续测量，以阐明儿童肥胖、血压、成熟速度以及异常心脏结构和功能之间的关系。我们计划研究的具体目标包括确定儿童血压、体型和身体成分对同一受试者几十年后的（1）血压、（2）心脏结构和（3）心脏功能的影响。我们可以分析 750 多项超声心动图研究，从中得出左心室质量指数 (LVMI)、室间隔厚度 (IVST) 和相对壁厚度 (RWT) 的结构测量值以及射血分数 (EF) 的功能测量值和左心室缩短分数（LVSF）。考虑到儿童和青少年时期的身体尺寸、身体成分和血压的某些值，这些拟议的分析有可能量化成年期高血压和心脏结构和功能异常的风险，即使这些值属于目前公认的正常值。如果我们在儿童中识别出预测高血压和/或成人心脏结构和功能异常的生物标志物，那么可以更彻底地评估具有这些生物标志物的儿童，并在发生不可逆的病理变化之前提供生活方式和/或药物干预。相反，我们提出的分析也有可能确定儿童期和青少年期的一系列身体尺寸、身体成分和血压范围，这些范围与以后生活中的高血压或异常心脏结构和功能无关，可用于预测成年后血压正常，没有心脏结构或功能异常。