Childhood risk factors and carotid atherosclerotic plaque in adulthood: The Cardiovascular Risk in Young Finns Study.

Autor: Koskinen JS; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland; Division of Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland; Department of Medicine, Satakunta Central Hospital, Sairaalantie 3, 28500, Pori, Finland. Electronic address: jskosk@utu.fi., Kytö V; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland; Heart Centre, Turku University Hospital, Hämeentie 11, 20521, Turku, Finland., Juonala M; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland; Division of Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland; Department of Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland., Viikari JSA; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland; Division of Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland; Department of Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland., Nevalainen J; Faculty of Social Sciences, University of Tampere, Kalevantie 5, 33100, Tampere, Finland., Kähönen M; Department of Clinical Physiology, University of Tampere, Arvo Ylpön katu 34, 33520, Tampere, Finland; Faculty of Medicine and Health Technology, University of Tampere, Arvo Ylpön katu 34, 33520, Tampere, Finland; Finnish Cardiovascular Research Center Tampere, University of Tampere, Kalevantie 4, 33100, Tampere, Finland., Lehtimäki T; Faculty of Medicine and Health Technology, University of Tampere, Arvo Ylpön katu 34, 33520, Tampere, Finland; Finnish Cardiovascular Research Center Tampere, University of Tampere, Kalevantie 4, 33100, Tampere, Finland; Department of Clinical Chemistry, University of Tampere, Arvo Ylpön katu 34, 33520, Tampere, Finland; Fimlab Laboratories, Arvo Ylpön katu 4, 33520, Tampere, Finland., Hutri-Kähönen N; Department of Pediatrics, Tampere University Hospital, Teiskontie 35, 33520, Tampere, Finland., Laitinen T; Department of Clinical Physiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland., Tossavainen P; Department of Pediatrics, Oulu University Hospital, Kajaanintie 50, 90220, Oulu, Finland; PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Aapistie 5 A, 90220, Oulu, Finland., Jokinen E; Department of Pediatrics, University of Helsinki, Stenbäckinkatu 11, 00290, Helsinki, Finland; Hospital for Children and Adolescents, Helsinki University Hospital, Stenbäckinkatu 9, 00290, Helsinki, Finland., Magnussen CG; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia., Raitakari OT; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland; Centre for Population Health Research, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2020 Jan; Vol. 293, pp. 18-25. Date of Electronic Publication: 2019 Nov 30.
DOI: 10.1016/j.atherosclerosis.2019.11.029
Abstrakt: Background and Aims: Carotid plaque is a specific sign of atherosclerosis and adults with carotid plaque are at increased risk for cardiovascular outcomes. Atherosclerosis has roots in childhood and pediatric guidelines provide cut-off values for cardiovascular risk factors. However, it is unknown whether these cut-offs predict adulthood advanced atherosclerosis.
Methods: The Cardiovascular Risk in Young Finns Study is a follow-up of children that begun in 1980 when 2653 participants with data for the present analyses were aged 3-18 years. In 2001 and 2007 follow-ups, in addition to adulthood cardiovascular risk factors, carotid ultrasound data was collected. Long-term burden, as the area under the curve, was evaluated for childhood (6-18 years) risk factors. To study the associations of guideline-based cut-offs with carotid plaque, both childhood and adult risk factors were classified according to clinical practice guidelines.
Results: Carotid plaque, defined as a focal structure of the arterial wall protruding into lumen >50% compared to adjacent intima-media thickness, was present in 88 (3.3%) participants. Relative risk for carotid plaque, when adjusted for age and sex, was 3.03 (95% CI, 1.76-5.21) for childhood dyslipidemia, 1.51 (95% CI, 0.99-2.32) for childhood elevated systolic blood pressure, and 1.93 (95% CI, 1.26-2.94) for childhood smoking. Childhood dyslipidemia and smoking remained independent predictors of carotid plaque in models additionally adjusted for adult risk factors and family history of coronary heart disease. Carotid plaque was present in less than 1% of adults with no childhood risk factors.
Conclusions: Findings reinforce childhood prevention efforts and demonstrate the utility of guideline-based cut-offs in identifying children at increased risk for adulthood atherosclerosis.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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