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

基本信息

批准号：
9181445
负责人：
TRUDY L BURNS
金额：
$ 264.19万
依托单位：
CINCINNATI CHILDRENS HOSP MED CTR
依托单位国家：
美国
项目类别：
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/9181445
关键词：
Address Adolescence Adolescent Adult Adverse effects Age Aneurysm Angina Pectoris 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 Follow-Up Studies Funding Growth Health Heart Heart Diseases Heart failure High Density Lipoprotein Cholesterol Incidence Individual International Intervention Joints LDL Cholesterol Lipoproteins Life Link Lipids Longitudinal Studies Longitudinal cohort study 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 measure Publications Publishing Questionnaires Race Recruitment Activity 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

项目摘要

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）：本研究计划的主要目的是确定儿童时期心血管 (CV) 危险因素（人体测量、血脂、血压）水平与成年时期心血管发病率和死亡率之间关系的性质。 NHLBI 儿童心血管风险降低计划指出，缺乏将儿童心血管风险因素水平与成年心血管终点联系起来的纵向研究，这是一个需要跨越的主要临床研究空白。这项研究将通过汇集 20 世纪 70 年代和 1980 年代启动的七项美国和国际主要纵向队列研究参与者的数据来缩小这一差距。这些研究都测量了儿童时期详细的心血管危险因素，并有跨越儿童期和成年期的随访数据。自 2009 年以来，他们一直作为国际儿童心血管队列 (i3C) 联盟进行合作，拥有一个行政组织、定期组织和数据共享会议以及 15 种联合出版物。本研究的具体目标 1 是找到 NIH 资助的五项美国纵向研究（BHS、MUSC、PFS、MCCS 和 NGHS）和两项国际研究（YFS 和 CDAH）的儿童参与者；使用通过医疗记录裁决验证的自我报告发病率来确定事件心血管终点（冠心病、心肌梗死、心力衰竭、外周动脉疾病和中风）；使用国家死亡指数识别死者并判定已故参与者的死因。在目标 2 中，这些数据将用于解决以下假设： 1) 不良儿童/青少年（3-19 岁）心血管危险因素水平（BMI、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、血压）与成年期心血管终点事件发生率增加。 2) 与任何个人风险因素相比，加权儿童/青少年风险因素（BMI、血压、血脂、年龄、性别和种族/民族）的心血管风险评分是成人心血管终点的更强预测因子。 3) 随着年龄从儿童期（3-11 岁）到青春期（11-19 岁）的增加，个体风险因素或 CV 风险评分与成人 CV 终点的关系变得更强。目标 3 将评估 CV 风险评分轨迹与成人 CV 终点的关联，重点关注儿童/青春期（假设 4）以及儿童/青春期与成年之间的轨迹（假设 5）。本提案的创新之处在于，它首次汇集了足够规模的队列（预计招募 22,883 人），并进行了儿童危险因素测量，并设定了随访期限（40 年），以便能够进行后续研究CV 事件发生时年龄的参与者。因此，它将为儿童危险因素如何导致成人心脏代谢疾病提供新的见解。