Kev sib raug zoo ntawm kev mob plawv thiab vascular phenotype

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Sau npe rau koj cov ntsiab lus tshwj xeeb thiab cov tshuaj tshwj xeeb uas txaus siab, thiab peb yuav phim cov ntaub ntawv koj muab nrog cov ntawv hauv peb cov ntaub ntawv dav dav thiab xa koj daim ntawv PDF ntawm email raws sijhawm.
Kev sib raug zoo ntawm cov kab mob plawv zoo tshaj plaws thiab vascular phenotype ntawm cov niam rog rog thiab lawv cov menyuam hnub nyoog 6 xyoo
Sau: 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 University of Helsinki thiab Helsinki University Tsev Kho Mob, Helsinki, Finland;2 Department of Congenital Heart Defects thiab Pediatric Cardiology, Silesian Medical University, Katowice, Poland, Zabrze FMS;3 Minerva Foundation Medical Research Institute, Helsinki, Finland;4 Department of Food and Nutrition, University of Helsinki, Helsinki, Finland;5LIKES Sports Activity thiab Health Research Center, Jyvaskyla, Finland;6 University of Helsinki Women's Hospital thiab Helsinki University Hospital hauv Helsinki, Finland;7 Folkhälsan Research Center, Helsinki, Finland;8 University of Helsinki thiab Helsinki Department of General Practice and Primary Health Care, University Hospital, Helsinki, Finland;9 Human Potential Transformation Research Program thiab Department of Obstetrics and Gynecology, Yang Luling School of Medicine, National University of Singapore, Singapore;10 Singapore Institute of Clinical Sciences (SICS), Science, Technology thiab Research Bureau (A* STAR), Singapore Communications: Linda Litwin Department of Congenital Heart Defects thiab Pediatric Cardiology, Zabrze FMS, Silesian Medical University, M.Sklodowskiej-Curie 9, Zabrze, 41-800, Poland Tel +48 322713401 Fax +48 322713401 Email [email tiv thaiv] Keeb Kwm: Cov noob caj noob ces thiab kev ua neej sib koom hauv tsev neeg tuaj yeem ua rau mob plawv, tab sis qhov uas lawv cuam tshuam rau cov qauv thiab kev ua haujlwm ntawm cov hlab ntsha thaum yau yog tsis meej.Peb tsom mus soj ntsuam kev koom tes ntawm kev noj qab haus huv zoo tshaj plaws ntawm cov hlab plawv hauv cov menyuam yaus thiab cov niam, leej niam subclinical atherosclerosis, thiab arterial phenotypes hauv cov menyuam yaus.Txoj Kev: Los ntawm Finnish Gestational Diabetes Prevention Study (RADIEL) longitudinal cohort, ib qho kev soj ntsuam hla ntawm 201 leej niam thiab cov menyuam yaus ntawm 6.1 ± 0.5 xyoo ntawm hnub nyoog ntsuas qhov zoo tshaj plaws kev noj qab haus huv plawv (BMI, ntshav siab, ntshav qabzib ceev, tag nrho cov roj cholesterol, Kev noj zaub mov zoo, Kev ua si lub cev, haus luam yeeb), lub cev muaj pes tsawg leeg, carotid ultra-high zaus ultrasound (25 thiab 35 MHz) thiab pulse yoj tshaj tawm.Cov txiaj ntsig: Peb pom tias tsis muaj kev sib raug zoo ntawm kev noj qab haus huv ntawm tus menyuam thiab leej niam, tab sis tau tshaj tawm cov pov thawj ntawm kev sib raug zoo ntawm cov ntsuas tshwj xeeb: tag nrho cov cholesterol (r = 0.24, P = 0.003), BMI (r = 0.17, P. = 0.02), Diastolic ntshav siab (r = 0.15, P = 0.03) thiab noj zaub mov zoo (r = 0.22, P = 0.002).Pediatric arterial phenotype tsis muaj dab tsi cuam tshuam nrog kev noj qab haus huv zoo tshaj plaws ntawm tus menyuam lossis niam.Nyob rau hauv ib tug multivariate regression txhais qauv hloov kho rau cov me nyuam cov poj niam txiv neej, hnub nyoog, systolic ntshav siab, lean lub cev loj, thiab lub cev rog feem pua, lub thickness ntawm carotid hlab ntsha intima-media nyob rau hauv cov me nyuam tsuas yog nws tus kheej correlated nrog lub thickness ntawm leej niam carotid artery intima. -media (nce ntawm 0.1 hli [95 %] CI 0.05, 0.21, P = 0.001] Lub thickness ntawm leej niam carotid artery intima-media nce 1 hli).Cov me nyuam ntawm cov niam uas muaj subclinical atherosclerosis txo qis carotid artery dilatation (1.1 ± 0.2 vs 1.2 ± 0.2% / 10 mmHg, P = 0.01) thiab nce carotid artery intima-media thickness (0.37 ± 0.04 vs 0.30 mm) ± 0.60 ± 0.000. Xaus: Cov ntsuas kev noj qab haus huv zoo tshaj plaws ntawm cov hlab plawv yog qhov muaj feem cuam tshuam nrog niam-me nyuam khub niam txiv thaum yau.Peb pom tsis muaj pov thawj ntawm qhov cuam tshuam ntawm cov menyuam yaus lossis leej niam txoj kev noj qab haus huv zoo tshaj plaws ntawm cov menyuam yaus arterial phenotypes.Maternal carotid artery intima-media thickness tuaj yeem kwv yees lub carotid artery intima-media thickness hauv cov menyuam yaus, tab sis nws cov txheej txheem hauv qab tseem tsis meej.Maternal subclinical atherosclerosis muaj feem xyuam rau cov hlab ntsha carotid nyob rau hauv thaum yau.Keywords: kab mob plawv, atherosclerosis, carotid artery intima-media thickness, pheej hmoo, cov me nyuam
Cov kev pheej hmoo ntawm cov hlab plawv ib txwm ua rau muaj qhov tshwm sim thiab kev loj hlob ntawm atherosclerosis.1,2 yam tseem ceeb muaj feem cuam tshuam ua ke, thiab lawv cov kev sib xyaw ua ke zoo li yuav ua rau muaj kev pheej hmoo ntau dua ntawm tus neeg mob plawv.3
Lub koom haum American Heart Association txhais cov kev noj qab haus huv zoo tshaj plaws (ICVH) raws li cov txheej txheem ntawm xya qhov ntsuas kev noj qab haus huv (lub cev qhov ntsuas lub cev (BMI), ntshav siab (BP), yoo ntshav qabzib, tag nrho cov roj cholesterol, kev noj zaub mov zoo, kev ua ub ua no, kev haus luam yeeb) los txhawb cov thawj coj. tiv thaiv kab mob plawv hauv cov menyuam yaus thiab cov neeg laus.4 ICVH tsis zoo cuam tshuam nrog subclinical atherosclerosis hauv cov neeg laus.5 ICVH thiab cov kab mob tsis zoo vascular phenotypes yog qhov ua tau zoo ntawm cov xwm txheej hauv plawv thiab kev tuag hauv cov neeg laus.6-8
Cov kab mob plawv ntawm cov niam txiv ua rau muaj kev pheej hmoo ntawm cov kab mob plawv hauv cov me nyuam.9 Cov xwm txheej ib puag ncig cuam tshuam nrog cov noob caj noob ces thiab kev ua neej ib txwm yog ob qho tib si suav tias yog cov cuab yeej muaj peev xwm, tab sis lawv txoj kev koom tes tseem tsis tau txiav txim siab.10,11 ib
Qhov kev sib raug zoo ntawm niam txiv thiab menyuam ICVH twb pom tseeb hauv cov menyuam hnub nyoog 11-12 xyoos.Nyob rau theem no, cov menyuam yaus ICVH muaj feem cuam tshuam rau carotid artery elasticity thiab tsis zoo cuam tshuam rau lub ncauj tsev menyuam femoral pulse wave velocity (PWV), tab sis nws tsis cuam tshuam rau hauv carotid artery intima-media thickness (IMT).12 Txawm li cas los xij, kev pheej hmoo ntawm cov hlab plawv ntawm hnub nyoog 12-18 xyoo yog txuam nrog kev nce hauv carotid IMT hauv nruab nrab-hnub nyoog lub neej, thiab tsis muaj dab tsi cuam tshuam nrog kev pheej hmoo ntawm tib lub sijhawm.13 Cov pov thawj hais txog lub zog ntawm cov koom haum no thaum yau tsis muaj.
Hauv peb txoj haujlwm yav dhau los, peb tsis pom qhov cuam tshuam ntawm gestational diabetes lossis niam txiv txoj kev ua neej nyob rau thaum yau anthropometry, lub cev muaj pes tsawg leeg lossis cov hlab ntsha loj thiab ua haujlwm.14 Lub hom phiaj ntawm qhov kev tshuaj ntsuam no yog qhov sib txawv ntawm cov kev pheej hmoo ntawm cov hlab plawv.Chav kawm thiab nws cov nyhuv ntawm arterial phenotype ntawm cov me nyuam.Peb xav tias leej niam ICVH thiab cov hlab ntsha hloov pauv rau cov kab mob plawv yuav cuam tshuam rau cov menyuam yaus ICVH thiab arterial phenotypes thaum yau.
Cov ntaub ntawv hla ntu yog los ntawm kev soj ntsuam rau xyoo ntawm Finnish Gestational Diabetes Prevention Study (RADIEL).Thawj qhov kev tshawb fawb tsim tau raug npaj rau lwm qhov.15 Nyob rau hauv luv luv, cov poj niam uas npaj yuav cev xeeb tub los yog nyob rau hauv thawj ib nrab ntawm cev xeeb tub thiab muaj kev pheej hmoo ntawm gestational diabetes (obesity thiab/los yog keeb kwm ntawm gestational diabetes) raug xaiv (N=728).Kev soj ntsuam ntawm cov hlab plawv 6 xyoo yog tsim los ua kev soj ntsuam ntawm cov niam-me nyuam mos ua khub, nrog rau cov niam txiv uas muaj thiab tsis muaj ntshav qab zib gestational, nrog rau qhov loj me me (~ 200).Txij thaum Lub Rau Hli 2015 txog Lub Tsib Hlis 2017, cov ntawv caw txuas ntxiv raug xa mus rau cov neeg tuaj koom kom txog rau thaum qhov txwv tau mus txog, thiab 201 khub ntawm ob-tuples raug xaiv.Kev soj ntsuam yog tsim los rau cov menyuam yaus hnub nyoog 5-6 xyoo kom ntseeg tau tias kev koom tes tsis muaj sedation, suav nrog niam-me nyuam mos binary pab pawg soj ntsuam ntawm lub cev loj thiab muaj pes tsawg leeg, ntshav siab, ceev cov ntshav qabzib thiab cov ntshav lipids, kev siv lub cev siv accelerometers, noj zaub mov zoo thiab Cov lus nug txog kev haus luam yeeb (niam), cov hlab ntsha Ultrasound thiab intraocular siab ntsuas thiab echocardiography hauv cov menyuam yaus.Cov ntaub ntawv muaj nyob rau hauv Cov Lus Qhia Ntxiv S1.Pawg Saib Xyuas Kev Ncaj Ncees ntawm Obstetrics thiab Gynecology, Pediatrics thiab Psychiatry ntawm Helsinki University Tsev Kho Mob tau pom zoo cov txheej txheem tshawb fawb (20/13/03/03/2015) rau kev soj ntsuam rau xyoo.Tag nrho cov niam ntawv tau txais kev tso cai sau ntawv tso cai thaum lub sijhawm sau npe.Txoj kev tshawb no tau ua raws li Kev Tshaj Tawm ntawm Helsinki.
Ib tus kws tshawb fawb txawj ntse (TS) siv 25 MHz thiab 35 MHz transducers nrog Vevo 770 system, thiab siv UHF22, UHF48 (zoo ib yam hauv nruab nrab zaus) thiab Vevo MD system (VisualSonics, Toronto, Canada) ua zaum kawg 52 khub niam thiab menyuam.Cov hlab ntsha carotid feem ntau tau pom 1 cm ze rau ntawm ob sab carotid qhov muag teev, thiab qhov chaw so yog nyob rau hauv txoj hauj lwm supine.Siv qhov zaus siab tshaj plaws uas tuaj yeem pom cov phab ntsa deb kom tau txais cov duab yeeb yaj kiab zoo uas npog 3-4 lub voj voog.Siv Vevo 3.0.0 (Vevo 770) nrog phau ntawv hluav taws xob calipers thiab VevoLab (Vevo MD) software los tshuaj xyuas cov duab offline.16 Lumen txoj kab uas hla thiab IMT tau ntsuas los ntawm ib tus neeg soj ntsuam txog kev paub (JKMS) thaum kawg ntawm diastole siv cov txheej txheem txiav), tsis paub txog cov yam ntxwv (Cov duab ntxiv S1).Peb tau tshaj tawm yav dhau los tias qhov sib txawv ntawm cov neeg soj ntsuam ntawm qhov sib txawv ntsuas los ntawm ultra-high-resolution ultrasound hauv cov menyuam yaus thiab cov neeg laus yog 1.2-3.7% nyob rau hauv txoj kab uas hla lumen, IMT yog 6.9-9.8%, thiab inter-coefficient ntawm kev sib txawv yog 1.5-4.6% nyob rau hauv lub lumen txoj kab uas hla., 6.0-10.4% ntawm IMT.Cov qhab nia carotid IMT Z tau hloov kho rau hnub nyoog thiab poj niam txiv neej tau suav nrog siv cov menyuam yaus noj qab haus huv tsis rog.17
Carotid artery lumen txoj kab uas hla tau ntsuas ntawm ncov systole thiab kawg-diastole los ntsuas carotid artery β stiffness Performance index thiab carotid artery expansion coefficient.Siv lub cuff me me uas tsim nyog, txoj kev oscillometric (Dinamap ProCare 200, GE) tau siv los sau cov ntshav siab systolic thiab diastolic rau kev ua haujlwm ntawm elasticity thaum lub sij hawm ultrasound imaging nyob rau hauv lub supine txoj hauj lwm ntawm sab caj npab.Carotid artery expansion coefficient thiab carotid artery β-stiffness Performance index yog xam los ntawm cov hlab ntsha carotid siv cov qauv hauv qab no:
Ntawm lawv, CCALAS thiab CCALAD yog thaj chaw carotid artery lumen thaum lub sij hawm systole thiab diastole feem;CCALDS thiab CCALDD yog cov kab mob carotid artery lumen txoj kab uas hla thaum lub sij hawm systole thiab diastole feem;SBP thiab DBP yog systolic thiab diastolic ntshav siab.18 Cov coefficient ntawm kev sib txawv ntawm carotid artery expansion coefficient nyob rau hauv tus soj ntsuam yog 5.4%, lub coefficient ntawm variation ntawm carotid hlab ntsha β stiffness Performance index yog 5.9%, thiab inter-observer coefficient ntawm variation ntawm carotid artery expansion yog 11.9% coefficient. thiab 12.8% ntawm carotid artery β txhav index.
Cov tsoos high-resolution ultrasound Vivid 7 (GE) nruab nrog ib tug 12 MHz linear transducer tau siv los soj ntsuam cov niam txiv carotid hlab ntsha rau cov quav hniav.Pib los ntawm cov hlab ntsha carotid uas nyob ze ntawm lub teeb, cov hlab ntsha carotid raug tshuaj xyuas ob sab los ntawm bifurcation thiab qhov sib thooj ntawm cov hlab ntsha carotid sab hauv thiab sab nraud.Raws li kev pom zoo ntawm Mannheim, cov quav hniav txhais tau tias yog 1. Local thickening ntawm phab ntsa hlab ntsha los ntawm 0.5 hli los yog 50% ntawm ib puag ncig IMT los yog 2. Tag nrho cov phab ntsa arterial thickness tshaj 1.5 hli.19 Lub xub ntiag ntawm cov quav hniav raug soj ntsuam los ntawm dichotomy.Tus neeg saib xyuas thawj (JKMS) nws tus kheej ua qhov ntsuas rov ua dua ntawm cov duab me me (N = 40) txhawm rau ntsuas qhov sib txawv ntawm cov neeg soj ntsuam, thiab tus neeg soj ntsuam thib ob (TS) ntsuas qhov sib txawv ntawm cov neeg soj ntsuam.Lub Cohen κ ntawm intra-observer variability thiab inter-observer variability yog 0.89 thiab 0.83, feem.
PWV tau ntsuas los ntawm tus kws saib xyuas neeg mob uas tau kawm los ntawm kev tshawb fawb los ntsuas cov hlab ntsha hauv cheeb tsam uas siv lub tshuab ntsuas ntsuas (Complior Analyse, Alam Medical, Saint-Quentin-Fallavier, France) thaum so hauv txoj hauj lwm supine.20 Sensors tau muab tso rau ntawm txoj hlab ntsha carotid, txoj cai radial artery, thiab txoj cai femoral artery los ntsuas lub hauv paus (txoj cai carotid artery-femoral artery) thiab peripheral (txoj cai carotid artery-radial artery) lub sijhawm hla.Siv daim kab xev ntsuas los ntsuas qhov kev ncua deb ntawm cov ntsiab lus kaw mus rau qhov ze tshaj 0.1 cm.Txoj cai carotid femoral artery nrug yog muab faib ua 0.8 thiab tom qab ntawd siv rau hauv nruab nrab PWV suav.Rov ua dua cov ntaub ntawv nyob rau hauv txoj hauj lwm supine.Ob cov ntaub ntawv tau txais thaum cov ntaub ntawv thib peb tau ua nyob rau hauv qhov chaw uas qhov sib txawv ntawm qhov ntsuas tau ntau dua 0.5 m / s (10%).Hauv kev teeb tsa ntau tshaj ob qhov kev ntsuas, qhov tshwm sim nrog tus nqi siab tshaj plaws yog siv rau kev tshuaj xyuas.Kev kam rau siab yog qhov tsis zoo uas ntsuas qhov sib txawv ntawm cov mem tes nthwv dej thaum kaw.Siv qhov nruab nrab ntawm tsawg kawg yog ob qhov kev ntsuas hauv qhov kev ntsuam xyuas zaum kawg.PWV ntawm 168 tus menyuam tuaj yeem ntsuas tau.Coefficient ntawm kev hloov pauv ntawm kev ntsuas rov qab yog 3.5% rau carotid-femoral artery PWV thiab 4.8% rau carotid-radial artery PWV (N=55).
Ib txheej ntawm peb qhov ntsuas binary yog siv los cuam tshuam leej niam lub subclinical atherosclerosis: lub xub ntiag ntawm carotid artery plaque, carotid artery IMT hloov lub hnub nyoog thiab tshaj 90 feem pua ​​​​ntawm peb cov qauv, thiab ntau dua 90 feem pua ​​​​PWV ntawm lub caj dab thiab femur yog matched. nrog lub hnub nyoog thiab pom cov ntshav siab.nees nkaum ib
ICVH yog ib txheej ntawm 7 binary indicators, As 0 mus rau 7 (tus qhab nia siab dua, ntau dua nyob rau hauv txoj kab nrog cov lus qhia).4 Cov ntsuas ICVH siv nyob rau hauv txoj kev tshawb no yog ua raws li cov ntsiab lus qub (peb qhov kev hloov kho tau ua)-Table Ntxiv S2) thiab suav nrog:
Kev noj zaub mov zoo yog ntsuas los ntawm tus menyuam Finnish Child Healthy Eating Index (ntau 1-42) thiab leej niam cov zaub mov noj qab haus huv (ntau 0-17).Ob qhov ntsuas ntsuas npog 4 ntawm 5 pawg suav nrog hauv qhov ntsuas kev noj zaub mov qub (tshwj tsis yog kev noj sodium).23,24 Tus nqi tseem ceeb ntawm kev noj zaub mov zoo thiab tsis zoo yog txhais tau tias yog 60% lossis ntau dua los cuam tshuam qhov zoo ntawm cov khoom noj qub.Qhov taw qhia txhais (nws yog qhov zoo tshaj yog tias ntau tshaj 3 ntawm 5 tus qauv tau ua tiav).Nrog rau kev noj qab haus huv Finnish cov menyuam yaus tsis ntev los no (87.7% rau cov ntxhais, 78.2% rau cov tub), yog tias qhov kev txwv tshwj xeeb ntawm poj niam txiv neej rau cov menyuam hnyav dhau lawm, tus menyuam BMI tau txhais tias tsis zoo, uas txawv me ntsis ntawm 85. % ntawm cov neeg Finnish.22 Vim tias muaj coob tus neeg kawm ntawv poob qis thiab muaj kev ntxub ntxaug tsawg heev (Table Ntxiv S1, 96% ntawm cov niam ua tau raws li ICVH cov qauv), cov poj niam cev xeeb tub thiab cov poj niam dag tau raug tshem tawm.ICVH tau muab faib ua cov pawg hauv qab no: qis (cov menyuam yaus 0-3, niam 0-2), nruab nrab (me nyuam 4, niam 3-4) thiab siab (me nyuam yaus thiab niam 5-6), muab lub sijhawm los sib piv ntau pawg .
Siv cov khoom siv hluav taws xob (Seca GmbH & Co. KG, Lub teb chaws Yelemees) los ntsuas qhov siab thiab qhov hnyav rau qhov ze tshaj 0.1 cm thiab 0.1 kg.Cov menyuam yaus BMI Z cov qhab nia raug tsim los nrog kev siv rau cov ntaub ntawv cov pej xeem Finnish tsis ntev los no.22 Lub cev muaj pes tsawg leeg dhau qhov kev ntsuam xyuas bioelectrical impedance (InBody 720, InBody Bldg, South Kauslim).
Cov ntshav siab so tau ntsuas los ntawm txoj kev oscillometric los ntawm sab caj npab sab xis hauv qhov chaw zaum (Omron M6W, Omron Healthcare Europe BV, Netherlands) nrog lub ntsej muag txaus.Qhov nruab nrab systolic thiab diastolic ntshav siab yog xam los ntawm ob qhov ntsuas qis tshaj plaws (yam tsawg kawg ntawm peb qhov ntsuas).Cov me nyuam cov ntshav siab Z tus nqi raug xam raws li cov lus qhia.25
Cov ntshav kuaj ntshav ntawm plasma qabzib thiab lipids tau sau raws li kev yoo mov.Cov txiaj ntsig tau los ntawm 3 cov menyuam yaus uas tsis paub meej kev ua raws li kev yoo mov (cov triglycerides ntau dhau, cov ntshav qabzib yoo mov, thiab glycosylated hemoglobin A1c (HbA1c)) raug tshem tawm los ntawm kev tshuaj xyuas.Tag nrho cov roj (cholesterol) tag nrho, qis lipoprotein tsawg (LDL) cov roj cholesterol, siab lipoprotein (HDL) cov roj cholesterol thiab triglycerides raug txiav txim los ntawm txoj kev enzymatic, ntshav qabzib thiab enzymatic hexokinase kev txiav txim siab, thiab HbA1c thiab immunoturbidimetric analyzer (Roche Diagnostics, Basel, Basel) .
Niam txoj kev noj zaub mov tau raug soj ntsuam los ntawm daim ntawv nug txog zaub mov thiab tshuaj xyuas ntxiv los ntawm kev noj zaub mov noj qab haus huv.Cov Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv Index yav dhau los tau raug lees paub tias yog cov cuab yeej muaj txiaj ntsig los cuam tshuam kev ua raws li Nordic Nutrition Recommendation 26 hauv thawj RADIEL pawg.24 Hauv luv luv, nws muaj 11 cov khoom xyaw, suav nrog kev noj zaub, txiv hmab txiv ntoo thiab txiv hmab txiv ntoo, cov khoom noj muaj fiber ntau, ntses, mis nyuj, cheese, roj ua noj, roj ntses, khoom noj txom ncauj, dej qab zib thiab khoom noj ceev.Qhov qhab nia siab dua qhia qhov siab dua qhov kev ua raws li cov lus pom zoo.Qhov zoo ntawm cov menyuam noj zaub mov tau raug soj ntsuam los ntawm 3-hnub cov ntaub ntawv noj zaub mov thiab tau soj ntsuam ntxiv los ntawm Finnish Children's Healthy Eating Index.Finnish Children's Healthy Eating Index yav dhau los tau raug lees paub nyob rau hauv Finnish cov menyuam yaus.23 Nws suav nrog tsib hom zaub mov: zaub, txiv hmab txiv ntoo thiab txiv hmab txiv ntoo;roj thiab margarine;cov khoom noj muaj suab thaj;ntses thiab ntses thiab zaub;thiab skimmed mis nyuj.Kev noj zaub mov tau qhab nia kom qhov kev noj ntau dua, qhov qhab nia siab dua.Tsuas yog cov khoom noj uas muaj suab thaj ntau, cov qhab nia yog thim rov qab.Ua ntej sib tw, kho lub zog kom tsawg los ntawm kev faib cov khoom noj (grams) los ntawm lub zog kom tsawg (kcal).Qhov qhab nia siab dua, qhov zoo dua ntawm cov menyuam noj zaub mov zoo.
Kev ua kom lub cev muaj zog (MVPA) tau ntsuas los ntawm kev ntsuas tus me nyuam hauv plab accelerometer (ActiGraph GT3X, ActiGraph, Pensacola, USA) thiab niam txiv caj npab (SenseWear ArmBand Pro 3).Qhia kom hnav lub monitor thaum tsaug zog thiab tsaug zog, tab sis lub sijhawm pw tsaug zog tsis suav nrog kev tshuaj xyuas.Tus menyuam saib xyuas sau cov ntaub ntawv ntawm tus lej ntsuas ntawm 30 Hz.Cov ntaub ntawv feem ntau yog lim, hloov mus rau 10-thib ob lub sijhawm suav, thiab tshuaj xyuas siv Evenson (2008) txiav taw tes (≥2296 cpm).27 Tus niam saib xyuas sau cov txiaj ntsig MET hauv 60-thib ob lub sijhawm.MVPA raug xam raws li tus nqi MET tshaj 3. Kev ntsuas tau zoo yog txhais tau tias tsawg kawg 2 hnub ua haujlwm thiab 1 hnub so (sau tsawg kawg 480 feeb hauv ib hnub) thiab 3 hnub ua haujlwm thiab 1 hnub so (tso tsawg kawg 720 feeb hauv ib hnub) rau niam.MVPA lub sij hawm yog xam raws li qhov hnyav nruab nrab [(nruab nrab MVPA feeb / hnub rau hnub ua haujlwm × 5 + nruab nrab MVPA feeb / hnub rau hnub so × 2) / 7], ntxiv rau, raws li feem pua ​​​​ntawm tag nrho cov sij hawm hnav.Cov ntaub ntawv kev tawm dag zog lub cev tsis ntev los no ntawm cov pej xeem Finnish tau siv los ua kev siv.28
Daim ntawv nug yog siv los muab cov ntaub ntawv hais txog leej niam haus luam yeeb, kab mob ntev, tshuaj, thiab kev kawm.
Cov ntaub ntawv qhia tau hais tias txhais tau tias ± SD, nruab nrab (interquartile ntau) lossis suav (feem pua).Ntsuam xyuas qhov kev faib tawm ib txwm muaj ntawm txhua qhov sib txawv tsis tu ncua raws li histogram thiab ib txwm QQ zajlus.
Kev ywj pheej qauv t xeem, Mann-Whitney U xeem, ib-txoj kev tsom xam ntawm variance, Kruskal-Wallis, thiab chi-square xeem tau siv raws li tsim nyog rau kev sib piv pawg (niam thiab menyuam, tub thiab ntxhais, los yog qis thiab nruab nrab thiab siab ICVH. ).
Lub Pearson lossis Spearman qib sib txheeb coefficient tau siv los tshawb txog kev sib koom ua ke ntawm tus yam ntxwv ntawm tus menyuam thiab leej niam.
Tus qauv multivariate linear regression tau siv los tsim cov qauv piav qhia rau cov menyuam yaus HDL cholesterol thiab carotid IMT.Kev xaiv sib txawv yog raws li kev sib raug zoo thiab cov kws tshaj lij kev soj ntsuam kev txiav txim siab, zam kev sib txawv tseem ceeb hauv cov qauv, thiab suav nrog cov teeb meem tsis meej pem.Multicollinearity raug soj ntsuam siv qhov sib txawv ntawm kev nce nqi, nrog tus nqi siab tshaj plaws ntawm 1.9.Multivariate linear regression tau siv los txheeb xyuas qhov sib cuam tshuam.
Ob-tailed P ≤ 0.05 tau teeb tsa los ua qhov tseem ceeb, tshwj tsis yog hauv kev txheeb xyuas kev sib txheeb ntawm kev txiav txim siab ntawm carotid artery IMT hauv cov menyuam yaus P ≤ 0.01.
Cov yam ntxwv ntawm cov neeg koom tau pom nyob rau hauv Table 1 thiab Supplementary Table S3.Piv nrog rau cov pej xeem siv, cov me nyuam cov qhab nia BMI Z thiab BP Z tau nce.Peb cov hauj lwm yav dhau los tau tshaj tawm cov ntaub ntawv ntxaws txog arterial morphology hauv cov menyuam yaus.14 Tsuas yog 15 (12%) cov menyuam yaus thiab 5 (2.7%) niam tau ntsib tag nrho cov txheej txheem ICVH (Cov Duab Ntxiv 2 thiab 3, Cov Lus Ntxiv S4-S6).
Cov niam txiv thiab menyuam mos cov qhab nia ICVH tsuas yog cuam tshuam rau cov tub (cov tub hluas: rs = 0.32, P = 0.01; cov ntxhais: rs=-0.18, P = 0.2).Thaum soj ntsuam raws li qhov sib txawv tsis tu ncua, kev soj ntsuam kev sib raug zoo ntawm niam-me nyuam mos muaj qhov tseem ceeb hauv kev ntsuas cov ntshav lipids, HbA1C, rog, diastolic ntshav siab, thiab kev noj zaub mov zoo (Cov duab ntxiv S4-S10).
Cov menyuam yaus thiab leej niam tus LDL, HDL, thiab tag nrho cov roj (cholesterol) sib raug zoo (r=0.23, P=0.003; r=0.35, P<0.0001; r=0.24, P=0.003, Daim duab 1).Thaum stratified los ntawm tus menyuam los ntawm poj niam txiv neej, kev sib raug zoo ntawm tus me nyuam thiab leej niam lub LDL thiab tag nrho cov roj cholesterol tseem ceeb tsuas yog hauv cov tub (Sab Ntxiv Table S7).Triglycerides thiab HDL cov roj (cholesterol) sib raug zoo nrog cov ntxhais lub cev rog feem pua ​​(rs = 0.34, P = 0.004; r = - 0.37, P = 0.002, raws li, Daim duab 1, Ntxiv Table S8).
Daim duab 1 Kev sib raug zoo ntawm tus menyuam thiab niam cov ntshav lipids.Scatter plot nrog linear regression kab (95% kev ntseeg siab ib ntus);(AC) cov ntshav lipid hauv niam thiab menyuam mos;(D) Tus ntxhais lub cev rog feem pua ​​thiab cov roj lipoprotein ceev.Cov txiaj ntsig tseem ceeb tau pom hauv qhov siab (P ≤ 0.05).
Cov ntawv luv: LDL, tsawg-density lipoprotein;HDL, high-density lipoprotein;r, Pearson correlation coefficient.
Peb pom tias muaj kev sib raug zoo ntawm HbA1C ntawm tus me nyuam thiab leej niam (r = 0.27, P = 0.004), tab sis nws tsis cuam tshuam txog kev yoo ntshav qabzib (P = 0.4).Cov menyuam yaus BMI Z qhab nia, tab sis tsis yog lub cev rog feem pua, tsis muaj zog cuam tshuam nrog niam BMI thiab lub duav-rau-hip piv (r = 0.17, P = 0.02; r = 0.18, P = 0.02, ntsig txog).Z tus nqi ntawm cov menyuam cov ntshav siab diastolic tsis muaj zog cuam tshuam nrog leej niam lub siab diastolic (r = 0.15, P = 0.03).Finnish cov me nyuam noj qab haus huv Performance index yog correlated nrog leej niam cov zaub mov noj qab haus huv Performance index (r = 0.22, P 0.002).Qhov kev sib raug zoo no tsuas yog pom hauv cov tub (r = 0.31, P = 0.001).
Tom qab tsis suav cov niam uas tau kho mob ntshav siab, hypercholesterolemia, lossis hyperglycemia, cov txiaj ntsig tau zoo ib yam.
Cov ncauj lus kom ntxaws arterial phenotype yog qhia nyob rau hauv Supplementary Table S9.Cov qauv vascular ntawm cov menyuam yaus yog ywj pheej ntawm cov yam ntxwv ntawm cov menyuam yaus (Sab Ntxiv Table S10).Peb tsis tau soj ntsuam ib qho kev koom tes ntawm cov menyuam yaus ICVH thiab cov qauv vascular lossis kev ua haujlwm.Hauv kev soj ntsuam ntawm cov menyuam yaus stratified los ntawm ICVH cov qhab nia, peb tau pom tias carotid IMT Z cov qhab nia ntawm cov menyuam yaus uas tsuas yog cov qhab nia nruab nrab tau nce piv nrog cov menyuam yaus uas tau qhab nia qis (txhais tau tias ± SD; tus qhab nia nruab nrab 0.41 ± 0.63 vs cov qhab nia qis- 0.07 ± 0.71, P. = 0.03, Supplementary Table S11).
Maternal ICVH tsis cuam tshuam nrog vascular phenotype ntawm cov menyuam yaus (Cov Lus Ntxiv S10 thiab S12).Cov menyuam yaus thiab niam txiv carotid artery IMT muaj kev sib raug zoo (Daim duab 2), tab sis kev sib raug zoo ntawm niam thiab menyuam yaus ntawm qhov sib txawv vascular txhav tsis muaj qhov tseem ceeb (Cov Lus Qhia Ntxiv 9, Daim Duab Ntxiv S11).Nyob rau hauv ib tug multivariate regression txhais qauv hloov kho rau cov me nyuam cov poj niam txiv neej, hnub nyoog, systolic ntshav siab, lean lub cev loj, thiab lub cev rog feem pua, leej niam carotid IMT yog tib tug ywj siab kwv yees ntawm cov me nyuam carotid IMT (hloov R2 = 0.08).Rau txhua txhua 1 hli nce ntawm leej niam carotid IMT, thaum yau carotid IMT nce 0.1 hli (95% CI 0.05, 0.21, P = 0.001) (Sab Ntxiv Table S13).Cov poj niam txiv neej ntawm tus menyuam tsis tau txo qhov cuam tshuam no.
Daim duab 2 Kev sib raug zoo ntawm cov hlab ntsha carotid intima-media thickness nyob rau hauv cov me nyuam thiab leej niam.Scatter plot nrog linear regression kab (95% kev ntseeg siab ib ntus);(A) niam thiab menyuam carotid IMT, (B) niam carotid IMT feem pua ​​thiab tus menyuam carotid IMT z-score.Cov txiaj ntsig tseem ceeb tau pom hauv qhov siab (P ≤ 0.05).
Cov qhabnias ntawm cov hlab ntsha ntawm leej niam muaj feem cuam tshuam nrog cov carotid artery expansion coefficient thiab β stiffness Performance index nyob rau hauv cov me nyuam (rs = -0.21, P = 0.007, rs = 0.16, P = 0.04, Supplementary Table S10, ntsig txog).Cov menyuam yug los rau cov niam uas muaj cov qhab nia vascular ntawm 1-3 muaj qhov coefficient ntawm carotid artery expansion dua li cov niam uas yug los nrog tus qhab nia ntawm 0 (txhais tau tias ± tus qauv sib txawv, 1.1 ± 0.2 vs 1.2 ± 0.2% / 10 mmHg, P = 0.01) thiab muaj kev nyiam nce carotid artery β txhav Performance index ( nruab nrab (IQR), 3.0 (0.7) thiab 2.8 (0.7), P = 0.052) thiab carotid hlab ntsha IMT (txhais tau tias ± SD, 0.37 ± 0.04 thiab 0.35 ± 0. mm, P=0.06) (Daim duab 3), Cov Lus Qhia Ntxiv S14).
Daim duab 3 Me nyuam vascular phenotype stratified los ntawm leej niam vascular qhab nia.Cov ntaub ntawv raug nthuav tawm raws li txhais tau tias + SD, P nrog tus qauv ywj pheej t xeem (A thiab C) thiab Mann-Whitney U xeem (B).Cov txiaj ntsig tseem ceeb tau pom hauv qhov siab (P ≤ 0.05).Cov qhab nia ntawm cov hlab ntsha ntawm leej niam: thaj tsam 0-3, ib txheej ntawm peb qhov ntsuas binary: muaj carotid plaque, lub thickness ntawm cov hlab ntsha carotid intima-media hloov kho los ntawm lub hnub nyoog thiab tshaj 90% hauv peb cov qauv, thiab lub ncauj tsev menyuam-femoral pulse yoj Tshaj tawm tshaj 90% yog cov hnub nyoog sib txuam thiab pom cov ntshav siab.nees nkaum ib
Cov qhabnias niam txiv (ICVH, vascular score) thiab cov qhabnias ntawm menyuam yaus thiab niam txiv tsis muaj feem cuam tshuam nrog cov kabmob arterial phenotype ntawm cov menyuam yaus (Table Ntxiv S10).
Nyob rau hauv qhov kev tshuaj ntsuam xyuas ntawm cov niam thiab lawv cov menyuam hnub nyoog 6 xyoo, peb tau tshawb xyuas kev sib koom ua ke ntawm cov menyuam yaus ICVH, niam txiv ICVH, thiab niam txiv subclinical atherosclerosis nrog cov qauv thiab kev ua haujlwm ntawm cov menyuam cov hlab ntsha.Qhov kev tshawb pom tseem ceeb yog tias tsuas yog leej niam tus kab mob subclinical atherosclerosis, thaum cov menyuam yaus thiab leej niam cov kev pheej hmoo ntawm cov hlab plawv tsis cuam tshuam nrog kev hloov pauv tsis zoo hauv cov menyuam yaus thaum ntxov vascular phenotypes.Qhov kev nkag siab tshiab no rau cov menyuam yaus txoj kev loj hlob vascular nce peb kev nkag siab txog kev cuam tshuam ntawm subclinical atherosclerosis.
Peb tshaj tawm cov pov thawj ntawm kev txo qis carotid artery dilatation thiab tiam sis nyob rau hauv carotid artery beta stiffness thiab carotid artery IMT nyob rau hauv cov me nyuam ntawm cov niam uas muaj kab mob plawv vascular hloov.Txawm li cas los xij, tsis muaj qhov cuam tshuam ncaj qha ntawm leej niam thiab tus menyuam mos vascular ntsuas ntsuas.Peb xav tias suav nrog leej niam cov quav hniav mus rau hauv cov vascular qhab nia ua rau nws cov nqi kwv yees nce ntxiv.
Peb tau pom muaj kev sib raug zoo ntawm cov hlab ntsha carotid IMT hauv cov menyuam yaus thiab cov niam txiv;Txawm li cas los xij, cov txheej txheem tseem tsis tau paub meej vim tias cov hlab ntsha carotid IMT hauv cov menyuam yaus yog ywj pheej ntawm tus yam ntxwv ntawm tus menyuam thiab leej niam.Kev sib koom ua ke ntawm cov menyuam cov qhab nia ICVH thiab carotid IMT tau pom qhov tsis sib xws, vim tias peb tsis tau pom qhov txawv ntawm qhov qis ICVH thiab siab ICVH.
Peb paub tias lwm yam tseem ceeb tuaj yeem ua lub luag haujlwm, suav nrog menyuam yaus lub taub hau ncig, uas tej zaum yuav yog ib qho tseem ceeb ntawm kev kwv yees ntawm cov hlab ntsha carotid nyob rau theem pib ntawm kev loj hlob.Tsis tas li ntawd, peb cov txiaj ntsig yuav tshwm sim los ntawm cov yam tsis tau ntsuas uas cuam tshuam rau kev loj hlob ntawm fetal vascular.Txawm li cas los xij, peb tau tshaj tawm yav dhau los tias kev xeeb tub ua ntej rog / rog thiab ntshav qab zib gestational tsis cuam tshuam rau menyuam yaus carotid IMT.14 Kev tshawb fawb ntxiv yog tsim nyog los tshawb txog qhov cuam tshuam ntawm cov hlab ntsha thiab kev ua haujlwm ntawm cov menyuam yaus txoj kev loj hlob thiab keeb kwm ntawm caj ces.
Cov koom haum tshaj tawm tau zoo ib yam nrog cov kev tshawb fawb yav dhau los ua rau cov tub ntxhais hluas, uas tau muab pov thawj ntawm kev koom tes ntawm niam txiv-me nyuam vascular phenotypes, suav nrog carotid IMT, txawm hais tias lub cev loj tsis tau hloov kho hauv kev tshuaj ntsuam.29 Qhov kev hloov pauv loj ntawm carotid IMT ntxiv qhia qhov no thiab cov neeg laus cov hlab ntsha tawv.30,31 ib
Kev sib koom ua ke ntawm niam txiv subclinical atherosclerosis thiab menyuam yaus vascular phenotype tsis txuas ntxiv los ntawm niam txiv ICVH.Qhov no zoo ib yam nrog cov kev tshawb fawb yav dhau los uas feem ntau ntawm qhov kev hloov pauv hauv cov menyuam yaus vascular phenotype tau piav qhia los ntawm cov caj ces yam tsis muaj kev pheej hmoo ntawm cov niam txiv thiab cov menyuam yaus.29
Tsis tas li ntawd, cov kev hloov pauv vascular tsis muaj dab tsi cuam tshuam nrog rau thaum yau ICVH, qhia txog qhov tseem ceeb ntawm cov menyuam yaus keeb kwm yav dhau los.Kev koom tes ntawm ib puag ncig zoo li hloov pauv nrog lub hnub nyoog ntawm cov menyuam yaus, raws li yav dhau los kev sib koom ua ke loj ntawm cov menyuam yaus hnub nyoog 11-12 tau tshaj tawm txog kev koom tes tseem ceeb ntawm cov menyuam yaus txoj hlab ntshav thiab ICVH.12