Ka pilina ma waena o ke olakino cardiovascular a me ka phenotype vascular

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ʻO ka pilina ma waena o ke olakino cardiovascular maikaʻi a me ka phenotype vascular o nā makuahine momona a me kā lākou mau keiki 6 makahiki.
Nā mea kākau: 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 Sarkola1,31Ka Haukapila o na Keiki, University of Ke Kulanui o Helsinki a me Helsinki University Hospitals, Helsinki, Finland;2 Ke Keʻena o nā Puʻuwai Congenital and Pediatric Cardiology, Silesian Medical University, Katowice, Polani, Zabrze FMS;3 Minerva Foundation Medical Research Institute, Helsinki, Finland;4 Ke Keʻena ʻO ka Meaʻai a me ka Nutrition, University of Helsinki, Helsinki, Finland;5LIKES Nā Hana Haʻuki a me ke Keʻena Noiʻi Ola, Jyvaskyla, Finland;6 Ke Kulanui o Helsinki Women's Hospital a me Helsinki University Hospital ma Helsinki, Finland;7 Folkhälsan Research Center, Helsinki, Finland;8 Ke Kulanui o Helsinki a me Helsinki Oihana Hoʻomaʻamaʻa Nui a me ka mālama ola kino kumu, Halemai Ke Kulanui, Helsinki, Finland;9 Ka Polokalamu Hoʻololi Hoʻololi kanaka a me ka 'Oihana o Obstetrics and Gynecology, Ke Kula Lapaʻau ʻo Yang Luling, National University of Singapore, Singapore;10 Singapore Institute of Clinical Sciences (SICS), Science, Technology and Research Bureau (A* STAR), Singapore Communications: Linda Litwin Keʻena o Congenital Heart Defects and Pediatric Cardiology, Zabrze FMS, Silesian Medical University, M.Sklodowskiej-Curie 9, Zabrze, 41-800, Polani Tel +48 322713401 Fax +48 322713401 Email [email protected] Background: Hiki i nā genetics a me nā nohona pili ʻohana ke hoʻopilikia i ka maʻi cardiovascular, akā ʻo ka nui o ka hopena i ke ʻano a me ka hana o nā aʻa i ka wā kamaliʻi. maopopo ole.Ua manaʻo mākou e loiloi i ka pilina ma waena o ke olakino cardiovascular maikaʻi i nā keiki a me nā makuahine, maternal subclinical atherosclerosis, a me nā phenotypes arterial i nā keiki.Nā ʻano hana: Mai ka Finnish Gestational Diabetes Prevention Study (RADIEL) longitudinal cohort, kahi hōʻuluʻulu cross-sectional o 201 makuahine-keiki keiki ma 6.1 ± 0.5 mau makahiki i loiloi ʻia ke olakino cardiovascular maikaʻi (BMI, ke koko, ka hoʻokē ʻai koko glucose, ka nui o ka cholesterol, ʻO ka maikaʻi o ka meaʻai, ka hana kino, ka puhi ʻana), ka haku ʻana o ke kino, ke kani kani kiʻekiʻe kiʻekiʻe o carotid (25 a me 35 MHz) a me ka wikiwiki o ka nalu pulse.Nā hualoaʻa: Ua ʻike mākou ʻaʻohe pilina ma waena o ke olakino cardiovascular maikaʻi o ke keiki a me ka makuahine, akā ua hōʻike ʻia nā hōʻike o ka correlation o nā hōʻailona kikoʻī: ka nui o ka cholesterol (r=0.24, P=0.003), BMI (r=0.17, P =0.02), ke koko diastolic (r=0.15, P=0.03) a me ka maikaʻi o ka meaʻai (r=0.22, P=0.002).ʻAʻohe pili o ka pediatric arterial phenotype me ke olakino cardiovascular maikaʻi o ke keiki a makuahine paha.I loko o ka multivariate regression interpretation model i hoʻoponopono ʻia no ke kāne o nā keiki, makahiki, systolic blood pressure, lean body mass, and body fat percentage, ka mānoanoa o ka carotid artery intima-media i loko o nā keiki i hoʻopili kūʻokoʻa ʻia me ka mānoanoa o ka intima carotid artery makuahine. -media (ka piʻi ʻana o 0.1 mm [95 %] CI 0.05, 0.21, P=0.001] Ua hoʻonui ʻia ka mānoanoa o ka maternal carotid artery intima-media e 1 mm).ʻO nā keiki o nā makuahine me ka subclinical atherosclerosis ua hoʻemi ʻia ka hoʻonui ʻana o ke aʻa carotid (1.1 ± 0.2 vs 1.2 ± 0.2% / 10 mmHg, P=0.01) a hoʻonui i ka mānoanoa carotid artery intima-media (0.37 ± 0.04 vs 0.35) ± 0.04 mm, P=0.04 mm. Ka Manaʻo Manaʻo: He heterogeneously nā hōʻailona olakino olakino maikaʻi i nā pālua makuahine-keiki i ka wā kamaliʻi.ʻAʻole i loaʻa iā mākou kahi hōʻike e pili ana i ka hopena o ke olakino cardiovascular maikaʻi o nā keiki a makuahine paha i nā phenotypes arterial o nā keiki.Hiki ke wānana ka mānoanoa o ke aʻaʻa carotid intima-media i nā keiki, akā ʻaʻole maopopo ke kumu kumu.Pili ka makuahine subclinical atherosclerosis me ka ʻoʻoleʻa o ke aʻa carotid kūloko i ka wā kamaliʻi.Hua'ōlelo: ka maʻi cardiovascular, atherosclerosis, carotid artery intima-media mānoanoa, nā mea pilikia, nā keiki
ʻO nā kumu pilikia o ka maʻi cardiovascular maʻamau e kōkua i ka hanana a me ka ulu ʻana o ka atherosclerosis.1,2 ʻO nā kumu pilikia e hui pū ana, a ʻo kā lākou hui ʻana e ʻoi aku ka wānana o ka pilikia cardiovascular o kēlā me kēia.3
Ua wehewehe ka American Heart Association i ke olakino cardiovascular maikaʻi (ICVH) ma ke ʻano he ʻehiku mau hōʻailona olakino (body mass index (BMI), ke koko (BP), ka glucose koko hoʻokēʻai, ka nui o ka cholesterol, ka maikaʻi o ka meaʻai, ka hana kino, ka puhi paka) ka pale ʻana i ka maʻi cardiovascular i nā keiki a me nā pākeke.Hoʻopili maikaʻi ʻia ʻo ICVH me subclinical atherosclerosis i ka wā makua.5 ʻO ka ICVH a me nā phenotypes vascular adverse he mau wānana hilinaʻi o nā hanana cardiovascular a me ka make i nā pākeke.6-8
ʻO ka maʻi cardiovascular o nā mākua e hoʻonui i ka pilikia o nā hanana cardiovascular i nā keiki.9 ʻO nā mea kaiapuni e pili ana i nā genetics a me nā ʻano nohona maʻamau ua manaʻo ʻia ʻo ia he mau mea hiki ke hana, akā ʻaʻole i hoʻoholo ʻia kā lākou hāʻawi.10,11
Ua ʻike ʻia ka pilina ma waena o ka makua a me ke keiki ICVH i nā keiki 11-12 makahiki.I kēia pae, pili ka ICVH o nā keiki i ka elasticity aʻaʻa carotid a pili maikaʻi ʻole i ka wikiwiki o ka hawewe pulse cervical femoral (PWV), akā ʻaʻole ia i hōʻike ʻia ma ka carotid artery intima-media mānoanoa (IMT).12 Eia naʻe, pili ka pilikia o ka maʻi cardiovascular ma waena o 12-18 mau makahiki me ka piʻi ʻana o ka carotid IMT i ke ola waena, a ʻaʻohe mea pili i nā mea pilikia i ka manawa like.13 Nalo nā hōʻike e pili ana i ka ikaika o kēia mau hui i ka wā kamaliʻi.
Ma kā mākou hana ma mua, ʻaʻole mākou i ʻike i nā hopena o ka maʻi diabetes gestational a i ʻole ka hana ʻana o ka nohona makuahine i ka anthropometry kamaliʻi, ka haku kino a i ʻole ka nui a me ka hana.14 ʻO ka manaʻo nui o kēia hoʻopaʻa ʻana ʻo ia ke ʻano o nā hanauna cross-generational o ka hōʻuluʻulu pilikia cardiovascular.Papa a me kona hopena i ka phenotype arterial o na keiki.Manaʻo mākou e hōʻike ʻia ka ICVH makuahine a me nā mea pani no ka maʻi cardiovascular i ka wā kamaliʻi ICVH a me nā phenotypes arterial i ka wā kamaliʻi.
ʻO ka ʻikepili cross-sectional mai kahi ʻeono makahiki ma hope o ka Finnish Gestational Diabetes Prevention Study (RADIEL).Ua hoʻolālā ʻia ka hoʻolālā noiʻi mua ma kahi ʻē aʻe.15 I ka pōkole, ua kiʻi ʻia nā wahine i manaʻo e hāpai a i ʻole i ka hapa mua o ka hāpai ʻana a ua piʻi aʻe ka pilikia o ka maʻi maʻi maʻi hānai (ka momona a / a i ʻole ka mōʻaukala o ka maʻi diabetes gestational) i kiʻi ʻia (N=728).Ua hoʻolālā ʻia ka hahai ʻana o ka maʻi cardiovascular he 6 mau makahiki ma ke ʻano he noiʻi nānā ʻana i nā pālua makuahine-pepe, me ka helu like o nā makuahine me ka maʻi diabetes gestational a me ka ʻole o ka maʻi maʻi gestational, me ka nui cohort i kuhikuhi mua ʻia (~200).Mai Iune 2015 a Mei 2017, ua hoʻouna ʻia nā kono hoʻomau i nā poʻe komo a hiki i ka palena ʻana, a ua kiʻi ʻia he 201 mau pālua ʻelua.Hoʻolālā ʻia ka hahai ʻana no nā keiki i piha i ka makahiki 5-6 e hōʻoia i ka launa pū ʻana me ka ʻole o ka hoʻomaha ʻana, me ka loiloi pūʻulu maternal-infant binary group no ka nui o ke kino a me ka haku ʻana, ke koko, ka glucose koko wikiwiki a me nā lipids koko, ka hoʻoikaika kino me ka hoʻohana ʻana i ka accelerometers, ka maikaʻi o ka meaʻai a me nā nīnau puhi puhi (makuahine), nā kīʻaha koko Ultrasound a me intraocular pressure ana a me ka echocardiography i nā keiki.Hoʻopaʻa ʻia ka loaʻa ʻana o ka ʻikepili ma ka Papa Pākuʻi S1.Ua ʻae ke Kōmike Ethics of Obstetrics and Gynecology, Pediatrics and Psychiatry of Helsinki University Hospital i ka protocol noiʻi (20/13/03/03/2015) no ka loiloi ʻeono makahiki.Ua loaʻa ka ʻae kākau ʻōlelo a nā makuahine a pau i ka manawa o ke kākau inoa ʻana.Ua mālama ʻia ka haʻawina e like me ka Hōʻike o Helsinki.
Hoʻohana ka mea noiʻi akamai (TS) i nā transducers 25 MHz a me 35 MHz me ka ʻōnaehana Vevo 770, a hoʻohana iā UHF22, UHF48 (ke ala waena like) a me Vevo MD ʻōnaehana (VisualSonics, Toronto, Kanada) ma ke ʻano he 52 mau pālua o ka makuahine a me ke keiki.Ua kiʻi ʻia ke aʻaʻa carotid maʻamau ma kahi o 1 knm kokoke i nā ʻōpuʻu carotid bilateral, a ʻo ke kūlana hoʻomaha ma ke kūlana ʻaoʻao.E hoʻohana i ka alapine kiʻekiʻe e hiki ke nānā i ka paia mamao e kiʻi i nā kiʻi kiʻiʻoniʻoni kiʻekiʻe e uhi ana i nā pōʻai puʻuwai 3-4.E hoʻohana iā Vevo 3.0.0 (Vevo 770) me nā calipers uila lima a me VevoLab (Vevo MD) lako polokalamu e kālailai i nā kiʻi ma waho.16 Lumen anawaena a me IMT ua anaia e ka mea nana ike (JKMS) ma ka hopena o ka diastole me ka hoʻohana 'ana i ka 'okiʻoki 'enehana, me ka ike ole i ke kumuhana (Supplementary Figure S1).Ua hōʻike mua mākou ʻo ka intra-observer coefficient o ka hoʻololi ʻana i ana ʻia e ka ultra-high-resolution ultrasound i nā keiki a me nā pākeke he 1.2-3.7% i ke anawaena lumen, IMT ʻo 6.9-9.8%, a ʻo ka inter-observer coefficient o ka hoʻololi ʻana. 1.5-4.6% i ke anawaena lumen., 6.0-10.4% o IMT.Ua helu ʻia ka helu carotid IMT Z no ka makahiki a me ke kāne me ka hoʻohana ʻana i ka kuhikuhi o nā keiki keʻokeʻo keʻokeʻo maikaʻi ʻole.17
Ua ana ʻia ke anawaena lumen aʻaʻa Carotid ma ka systole kiʻekiʻe a me ka diastole hope e loiloi i ka helu ʻoʻoleʻa β a me ka hoʻonui ʻana o ke aʻa carotid.Me ka hoʻohana ʻana i kahi cuff kūpono, ua hoʻohana ʻia ke ʻano oscillometric (Dinamap ProCare 200, GE) no ka hoʻopaʻa ʻana i ke koko systolic a me ka diastolic no ka helu ʻana i ka hana elastic i ka wā o ke kiʻi ultrasound ma ke kūlana supine o ka lima ʻākau.Ua helu ʻia ka helu helu hoʻonui ʻana o ke aʻaʻa carotid a me ka index β-stiffness aʻaʻa carotid mai ke aʻaʻa carotid me ka hoʻohana ʻana i kēia ʻano:
Ma waena o lākou, ʻo CCALAS a me CCALAD ka ʻāpana lumen o ka carotid artery maʻamau i ka systole a me ka diastole;ʻO CCALDS a me CCALDD ke anawaena lumen o ke aʻa carotid maʻamau i ka systole a me ka diastole;ʻO SBP a me DBP ke koko systolic a me ka diastolic.18 He 5.4% ka helu o ka hoʻololi ʻana o ka hoʻonui ʻana o ke aʻa carotid i loko o ka mea nānā, ʻo ka coefficient o ka hoʻololi ʻana o ke aʻa carotid β stiffness index he 5.9%, a ʻo ka coefficient inter-observer o ka hoʻololi ʻana o ka hoʻonui ʻana o ka carotid artery he 11.9% coefficient a me 12.8% o ka carotid artery β stiffness index.
Ua hoʻohana ʻia ka ultrasound high-resolution Vivid 7 (GE) i hoʻolako ʻia me kahi transducer linear 12 MHz no ka nānā hou ʻana i ke aʻa carotid makuahine no ka plaque.E hoʻomaka ana mai ke aʻaʻa carotid maʻamau ma kahi kokoke i ka puʻupuʻu, e nānā ʻia ke aʻaʻa carotid ma o ka bifurcation a me ka ʻāpana kokoke o ke aʻa carotid kūloko a me waho.Wahi a ka Mannheim consensus, ua wehewehe ʻia ka plaque ma ke ʻano he 1. ʻO ka mānoanoa kūloko o ka pā moku e 0.5 mm a i ʻole 50% o ka IMT a puni a i ʻole 2. ʻO ka nui o ka mānoanoa o ka pā arterial ma mua o 1.5 mm.19 Ua helu ʻia ke ʻano o ka plaque e kahi dichotomy.Hana kūʻokoʻa ka mea nānā mua (JKMS) i nā ana hou ʻana ma kahi ʻāpana o nā kiʻi (N = 40) e loiloi i ka ʻokoʻa intra-nānā, a ʻo ka mea nānā ʻelua (TS) loiloi i ka ʻokoʻa o ka mea nānā.ʻO ka Cohen κ o ka ʻokoʻa intra-nānā a me ka ʻokoʻa o nā mea nānā i waena o 0.89 a me 0.83.
Ua ana ʻia ʻo PWV e kekahi kahu noiʻi i aʻo ʻia no ka loiloi ʻana i ka ʻoʻoleʻa arterial āpana me ka hoʻohana ʻana i kahi sensor mechanical (Complior Analyse, Alam Medical, Saint-Quentin-Fallavier, Palani) ʻoiai e hoʻomaha ana ma ke kūlana supine.20 Hoʻonoho ʻia nā mea ʻike ma ke aʻaʻa carotid ʻākau, ke aʻaʻa radial ʻākau, a me ke aʻaʻa femoral akau no ka loiloi ʻana i ke aʻa waena (aʻaʻa carotid akau-femoral aʻa) a me ke aʻa (aʻaʻa carotid aʻoaʻo-radial akau) manawa transit.E hoʻohana i kahi ana lipine e ana i ka mamao pololei ma waena o nā kiko hoʻopaʻa leo i ka 0.1 knm kokoke loa.Hoʻonui ʻia ka mamao o ke aʻaʻa carotid femoral akau i ka 0.8 a laila hoʻohana ʻia i ka helu PWV waena.E hana hou i ka hoʻopaʻa ʻana ma ke kū ʻana.Ua loaʻa nā moʻolelo ʻelua i ka wā i hana ʻia ai ke kolu o ka moʻolelo ma kahi hoʻonohonoho i ʻoi aku ka ʻokoʻa ma waena o nā ana ma mua o 0.5 m/s (10%).I ka hoʻonohonoho ʻana o nā ana ʻoi aku ma mua o ʻelua, hoʻohana ʻia ka hopena me ka waiwai hoʻomanawanui haʻahaʻa no ka nānā ʻana.ʻO ka hoʻomanawanui he mea hoʻohālikelike maikaʻi e helu ana i ka loli o ka nalu pulse i ka wā e hoʻopaʻa ai.E hoʻohana i ka awelika o ʻelua mau ana ma ka nānā hope.Hiki ke ana 'ia ka PWV o 168 keiki.ʻO ka coefficient o ka hoʻololi ʻana o nā ana hou ʻana he 3.5% no ke aʻa carotid-femoral PWV a me 4.8% no ke aʻa carotid-radial PWV (N=55).
Hoʻohana ʻia kahi pūʻulu o nā hōʻailona binary ʻekolu e hōʻike i ka atherosclerosis subclinical o ka makuahine: ka hele ʻana o ka carotid artery plaque, carotid artery IMT i hoʻoponopono ʻia i ka makahiki a ʻoi aku i ka 90th percentile i kā mākou hāpana, a ʻoi aku ma mua o 90 pakeneka Ua kūlike ka PWV o ka ʻāʻī a me ka femur. me ka makahiki a me ke koko maikai loa.iwakāluakumakahi
ʻO ICVH kahi hoʻonohonoho o nā hōʻailona binary 7 me kahi hui kumulative mai 0 a 7 (ʻo ke kiʻekiʻe o ka helu, ʻoi aku ka nui o ka laina me nā alakaʻi).4 Ua kūlike nā hōʻailona ICVH i hoʻohana ʻia i kēia haʻawina me ka wehewehe kumu (ua hana ʻia ʻekolu mau hoʻololi)-Paʻa S2 Pākuʻi) a me:
ʻIke ʻia ka maikaʻi o ka meaʻai e ke keiki Finnish Child Healthy Eating Index (pae 1-42) a me ka papa kuhikuhi meaʻai olakino a ka makuahine (pae 0-17).Hoʻopili ʻia nā papa kuhikuhi ʻelua i ka 4 o nā ʻāpana 5 i hoʻokomo ʻia i ka hōʻailona meaʻai kumu (koe wale ka sodium intake).23,24 Ua wehewehe ʻia ka waiwai koʻikoʻi o ka maikaʻi o ka meaʻai maikaʻi a me ka maikaʻi ʻole e like me 60% a i ʻole e hōʻike i ka maikaʻi o ka meaʻai kumu.ʻO ka wehewehe ʻana o ka hōʻailona (kūpono inā ʻoi aku ma mua o 3 o nā pae 5 i hoʻokō ʻia).E pili ana i ka heluna keiki keiki Finnish olakino hou loa (87.7% no nā kaikamahine, 78.2% no nā keikikāne), inā i ʻoi aku ka paepae o ke kāne no nā keiki kaumaha nui, ua wehewehe ʻia ka BMI o ke keiki he mea kūpono ʻole, ʻokoʻa iki mai 85 % o ka heluna kanaka Finnish.22 Ma muli o ka nui o ka poʻe haʻalele i ke kula a me ka haʻahaʻa haʻahaʻa haʻahaʻa loa (Pākuʻi Pākuʻi S1, 96% o nā makuahine i hoʻokō i nā koina ICVH), ua kāpae ʻia ka hana kino o nā wahine hāpai a moe ʻole.Hoʻokaʻawale ʻia ʻo ICVH i nā ʻāpana penei: haʻahaʻa (keiki 0-3, makuahine 0-2), waena (keiki 4, makuahine 3-4) a me ke kiʻekiʻe (keiki a me nā makuahine 5-6), e hāʻawi ana i kahi manawa e hoʻohālikelike ai i nā ʻano like ʻole. .
E hoʻohana i nā lako uila (Seca GmbH & Co. KG, Kelemānia) e ana i ke kiʻekiʻe a me ke kaumaha i ka 0.1 knm kokoke loa a me 0.1 kg.Hoʻokumu ʻia nā helu BMI Z o nā keiki e pili ana i ka hoʻonohonoho ʻikepili heluna kanaka Finnish hou loa.22 Ua hala ka hoʻokumu kino kino i ka loiloi impedance bioelectrical (InBody 720, InBody Bldg, South Korea).
Ua ana ʻia ke kahe koko hoʻomaha e ke ʻano oscillometric mai ka lima ʻākau i kahi noho (Omron M6W, Omron Healthcare Europe BV, Netherlands) me kahi cuff lawa.ʻO ka awelika systolic a me ke koko diastolic e helu ʻia mai nā ana haʻahaʻa ʻelua (ʻo ka liʻiliʻi o ʻekolu ana).Ua helu ʻia ka waiwai Z ke koko koko o nā keiki e like me nā alakaʻi.25
Ua hōʻiliʻili ʻia nā laʻana koko o ka glucose plasma a me nā lipid ma lalo o nā kūlana hoʻokēʻai.Nā hualoaʻa mai 3 keiki me ka maopopo ʻole ka hoʻokē ʻai ʻana (ke kiʻekiʻe triglycerides kiʻekiʻe, ka hoʻokē ʻai koko glucose, a me ka glycosylated hemoglobin A1c (HbA1c)) i kāpae ʻia mai ka nānā ʻana.ʻO ka nui o ka cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol a me nā triglycerides e hoʻoholo ʻia e ke ʻano enzymatic, ka glucose plasma a me ka hoʻoholo hexokinase enzymatic, a me ka HbA1c a me ka immunoturbidimetric analyzer (Roche Diagnostics, Basel, Switzerland) no ka loiloi .
Ua helu ʻia ka ʻai ʻana o ka makuahine e ka nīnau nīnau pinepine meaʻai a nānā hou ʻia e ka helu ʻai meaʻai olakino.Ua hōʻoia mua ʻia ka Healthy Food Intake Index ma ke ʻano he mea pono e noʻonoʻo ai i ka hoʻokō ʻana me Nordic Nutrition Recommendation 26 i ka hui RADIEL kumu.24 I ka pōkole, loaʻa iā ia he 11 mau meaʻai, e uhi ana i ka ʻai ʻana i nā mea kanu, nā huaʻai a me nā hua, nā cereals kiʻekiʻe-fiber, ka iʻa, ka waiū, ka paʻakai, ka aila kuke, nā kīʻaha momona, nā meaʻai, nā mea inu kō a me nā meaʻai wikiwiki.ʻO ke kiʻekiʻe o ka helu e hōʻike ana i ke kiʻekiʻe o ka hoʻokō ʻana i nā ʻōlelo paipai.Ua loiloi ʻia ka maikaʻi o ka meaʻai a nā keiki ma o nā moʻolelo meaʻai 3-lā a loiloi hou ʻia e ka Finnish Children's Healthy Eating Index.Ua hoʻopaʻa mua ʻia ka Finnish Children's Healthy Eating Index i ka heluna pediatric pediatric Finnish.23 He ʻelima ʻano meaʻai: nā mea kanu, nā huaʻai a me nā hua;ka aila a me ka margarine;nā meaʻai nui i ke kō;nā iʻa a me nā iʻa a me nā mea kanu;a me ka waiu waiu.Hoʻopili ʻia ka ʻai ʻana i mea e ʻoi aku ka kiʻekiʻe o ka ʻai, ʻoi aku ka kiʻekiʻe o ka helu.Ma waho aʻe o nā meaʻai i loaʻa i ka nui o ke kō, ua hoʻohuli ʻia ka helu.Ma mua o ka helu ʻana, hoʻoponopono i ka lawe ʻana i ka ikehu ma ka puʻunaue ʻana i ka ʻai (grams) me ka ʻai ikehu (kcal).ʻO ke kiʻekiʻe o ka helu, ʻoi aku ka maikaʻi o ka ʻai a nā keiki.
Ua ana ʻia ka hoʻoikaika kino haʻahaʻa a me ka ikaika (MVPA) me ka hoʻohana ʻana i ka accelerometer hip keiki (ActiGraph GT3X, ActiGraph, Pensacola, USA) a me ke kāʻei lima o ka makuahine (SenseWear ArmBand Pro 3).Aʻo ʻia e ʻaʻahu i ka monitor i ka wā ala a me ka manawa hiamoe, akā ua kāpae ʻia ka manawa hiamoe mai ka nānā ʻana.ʻOhi ke keiki kiaʻi i ka ʻikepili ma kahi laʻana o 30 Hz.Hoʻopili pinepine ʻia ka ʻikepili, hoʻololi ʻia i ka helu 10-kekona manawa, a hoʻopaʻa ʻia me ka hoʻohana ʻana i ke kiko ʻoki Evenson (2008) (≥2296 cpm).27 ʻOhi ka māka makuahine i nā waiwai MET i ka manawa 60-kekona.Ua helu ʻia ka MVPA ma ke ʻano o ka waiwai MET ma mua o 3. Ua wehewehe ʻia ke ana kūpono ma ka liʻiliʻi he 2 mau lā hana a me 1 hopena pule (hoʻopaʻa ʻia ma kahi o 480 mau minuke i kēlā me kēia lā) a me 3 mau lā hana a me 1 hopena pule (hoʻopaʻa ʻia ma kahi o 720 mau minuke i kēlā me kēia lā) no ka makuahine.Ua helu ʻia ka manawa MVPA ma ke ʻano he awelika paona [(ʻawelika MVPA minuke/lā ma nā lā pule × 5 + awelika MVPA mau minuke/lā ma nā hopena pule × 2)/7], ma ke ʻano he pākēneka o ka nui o ka manawa komo.Ua hoʻohana ʻia ka ʻikepili hana kino hou loa o ka heluna kanaka Finnish ma ke ʻano he kuhikuhi.28
Ua hoʻohana ʻia ka nīnau nīnau no ka loaʻa ʻana o ka ʻike e pili ana i ka puhi ʻana o ka makuahine, nā maʻi maʻi mau, nā lāʻau lapaʻau, a me ka hoʻonaʻauao.
Hōʻike ʻia ka ʻikepili ma ke ʻano he mean ± SD, median (interquartile range) a i ʻole helu (pakeneka).E loiloi i ka puunaue maʻamau o nā mea hoʻololi mau a pau e pili ana i ka histogram a me ka pā QQ maʻamau.
Ua ho'ohana 'ia ka ho'ā'o t ho'ā'o kū'oko'a, ho'ā'o Mann-Whitney U, ho'ā'o ho'okahi ala o ka 'oko'a, Kruskal-Wallis, a me ka ho'ā'o chi-square e like me ke kūpono no nā pū'ulu ho'ohālikelike (makuahine a me ke keiki, ke keikikāne a me ke kaikamahine, a i 'ole ICVH ha'aha'a a me ke ki'eki'e. ).
Ua hoʻohana ʻia ka coefficient correlation rank Pearson a i ʻole Spearman e ʻimi i ka hui univariate ma waena o nā ʻano o ke keiki a me ka makuahine.
Ua hoʻohana ʻia ke ʻano hoʻohālikelike laina multivariate e hoʻokumu i kahi kumu hoʻohālike no ka cholesterol HDL o nā keiki a me ka carotid IMT.Hoʻokumu ʻia ke koho ʻokoʻa ma luna o ka hoʻoponopono ʻana a me ka hoʻoholo ʻana i ke kauka loea, pale i ka multicollinearity koʻikoʻi i loko o ke kŘkohu, a me nā mea hiki ke hoʻohālikelike.Hoʻopili ʻia ka multicollinearity me ka hoʻohana ʻana i ka helu inflation varice, me ka nui o ka waiwai o 1.9.Ua hoʻohana ʻia ka multivariate linear regression e nānā i ka pilina.
ʻO P ≤ 0.05 mau huelo ʻelua i hoʻonohonoho ʻia i mea koʻikoʻi, koe naʻe i ka hoʻopili ʻana i nā mea hoʻoholo o ka carotid artery IMT i nā keiki me ka P ≤ 0.01.
Hōʻike ʻia nā hiʻohiʻona o nā mea komo ma ka Papa 1 a me ka Papa Pākuʻi S3.Ke hoʻohālikelike ʻia me ka heluna kanaka, ua hoʻonui ʻia ka helu BMI Z a me ka helu BP Z.Ua hōʻike kā mākou hana mua i ka ʻikepili kikoʻī e pili ana i ka morphology arterial i nā keiki.14 ʻO 15 wale nō (12%) keiki a me 5 (2.7%) makuahine i hālāwai i nā pae ICVH āpau (Nā Kiʻi 2 a me 3, Nā Papa Hoʻohui S4-S6).
ʻO ka helu ICVH kumulative makuahine a me ka pēpē e pili wale ana i nā keikikāne (nā keikikāne: rs=0.32, P=0.01; kaikamahine: rs=-0.18, P=0.2).Ke kālailai ʻia ma ke ʻano he hoʻololi mau, he koʻikoʻi ko ka maternal-infant univariate correlation analysis i ke ana ʻana o nā lipids koko, HbA1C, ka momona, ke koko diastolic, a me ka maikaʻi o ka meaʻai (Supplementary Figures S4-S10).
Hoʻopili ʻia ka LDL, HDL, a me ka cholesterol a pau o nā keiki a me ka makuahine (r=0.23, P=0.003; r=0.35, P<0.0001; r=0.24, P=0.003, Kiʻi 1).Ke hoʻopaʻa ʻia e ke kāne o ke keiki, ʻoi aku ka koʻikoʻi o ka pilina ma waena o ka LDL o ke keiki a me ka makuahine a me ka kolamu a pau i nā keikikāne wale nō (Paʻa Pākuʻi S7).Hoʻopili ʻia ʻo Triglycerides a me HDL cholesterol me ka pākēneka momona o ke kino o nā kaikamahine (rs=0.34, P=0.004; r=-0.37, P=0.002, kēlā me kēia, Kiʻi 1, Papa Pākuʻi S8).
Kiʻi 1 Ka pilina ma waena o ke keiki a me nā lipid koko o ka makuahine.E hoʻopuehu me ka laina regression laina (95% hilinaʻi manawa);(AC) ka pae koko o ka makuahine a me ke keiki keiki;(D) ka pakeneka momona kino o ke kaikamahine a me ka cholesterol kiʻekiʻe kiʻekiʻe lipoprotein.Hōʻike ʻia nā hopena koʻikoʻi ma ka wiwo ʻole (P ≤ 0.05).
Nā pōkole: LDL, lipoprotein haʻahaʻa haʻahaʻa;HDL, lipoprotein kiʻekiʻe;r, ka huina hoopili Pearson.
Ua ʻike mākou he pilina koʻikoʻi ma waena o ka HbA1C o ke keiki a me ka makuahine (r=0.27, P=0.004), akā ʻaʻole pili i ka hoʻokē ʻai koko glucose (P=0.4).ʻO ka helu BMI Z o nā keiki, akā ʻaʻole ka pākēneka momona o ke kino, ua hoʻopili nāwaliwali ʻia me ka BMI o ka makuahine a me ka ratio pūhaka-a-hip (r=0.17, P=0.02; r=0.18, P=0.02, kēlā me kēia).ʻO ka waiwai Z o ke koko diastolic o nā keiki ua pili nāwaliwali me ke koko diastolic o ka makuahine (r=0.15, P=0.03).Hoʻopili ʻia ka papa kuhikuhi meaʻai olakino a nā keiki Finnish me ka helu ʻai meaʻai olakino a ka makuahine (r=0.22, P 0.002).Ua ʻike ʻia kēia pilina ma nā keikikāne (r=0.31, P=0.001).
Ma hope o ka haʻalele ʻana i nā makuahine i mālama ʻia no ka hypertension, hypercholesterolemia, a i ʻole hyperglycemia, ua kūlike nā hopena.
Hōʻike ʻia ka phenotype arterial kikoʻī ma ka Papa Pākuʻi S9.Kūʻokoʻa ka ʻōnaehana vascular o nā keiki i nā hiʻohiʻona o nā keiki (Supplementary Table S10).ʻAʻole mākou i ʻike i kahi pilina ma waena o ka ICVH kamaliʻi a me ka hoʻolālā vascular a i ʻole ka hana.I ka hoʻopaʻa ʻana i nā keiki i hoʻopaʻa ʻia e nā helu ICVH, ʻike mākou ua hoʻonui ʻia nā helu carotid IMT Z o nā keiki me nā helu haʻahaʻa i hoʻohālikelike ʻia me nā keiki me nā helu haʻahaʻa (mean ± SD; helu haʻahaʻa 0.41 ± 0.63 vs haʻahaʻa haʻahaʻa- 0.07 ± 0.71, P = 0.03, Papa Pākuʻi S11).
ʻAʻole pili ʻia ka ICVH makuahine me ka phenotype vascular o nā keiki (Supplementary Tables S10 a me S12).Hoʻopili ʻia nā keiki a me ka maternal carotid artery IMT (Figure 2), akā ʻaʻole koʻikoʻi ka pilina o ka makuahine-keiki ma waena o nā ʻokoʻa ʻokoʻa vascular stiffness (Suppplementary Table 9, Supplementary Figure S11).I loko o ka multivariate regression interpretation model i hoʻoponopono ʻia no ke kāne o nā keiki, makahiki, systolic blood pressure, lean body mass, and body fat percentage, maternal carotid IMT ʻo ia wale nō ka wānana kūʻokoʻa o ka carotid IMT o nā keiki (hoʻoponopono ʻia R2 = 0.08).No kēlā me kēia 1 mm ka piʻi ʻana o ka carotid IMT makuahine, ua hoʻonui ʻia ka IMT carotid kamaliʻi e 0.1 mm (95% CI 0.05, 0.21, P = 0.001) (Paʻi Paʻi S13).ʻAʻole i hoʻēmi ke kāne o ke keiki i kēia hopena.
Kiʻi 2 Ka pilina ma waena o ka mānoanoa o ka intima-media ma waena o nā keiki a me nā makuahine.E hoʻopuehu me ka laina regression laina (95% hilinaʻi manawa);(A) maternal a me keiki carotid IMT, (B) maternal carotid IMT percentile a me keiki carotid IMT z-helu.Hōʻike ʻia nā hopena koʻikoʻi ma ka wiwo ʻole (P ≤ 0.05).
Hoʻopili ʻia ka helu moku koko makuahine me ka carotid artery expansion coefficient a me β stiffness index i nā keiki (rs=-0.21, P=0.007, rs=0.16, P=0.04, Pākuʻi Pākuʻi S10, kēlā me kēia).ʻO nā keiki i hānau ʻia e nā makuahine me ka helu vascular o 1-3 he haʻahaʻa haʻahaʻa o ka hoʻonui ʻana i ke aʻa carotid ma mua o nā mea i hānau ʻia e nā makuahine me ka helu o 0 (mean ± standard deviation, 1.1 ± 0.2 vs 1.2 ± 0.2%/10 mmHg, P= 0.01) a aia ka manaʻo e hoʻonui i ka ʻāʻī carotid β stiffness index (median (IQR), 3.0 (0.7) a me 2.8 (0.7), P=0.052) a me ka carotid artery IMT (mean ± SD, 0.37 ± 0.04 a me 0.35 ± 0.35 ± mm, P=0.06) (Figure 3), Pākuʻi Pākuʻi S14).
Kiʻi 3 ʻO ke ʻano o ke kino o ke keiki i hoʻopaʻa ʻia e ka helu ʻana o ka maʻi maʻi.Hōʻike ʻia nā ʻikepili ma ke ʻano he mean + SD, P me ka hoʻāʻo t hoʻohālike kūʻokoʻa (A a me C) a me ka hōʻike Mann-Whitney U (B).Hōʻike ʻia nā hopena koʻikoʻi ma ka wiwo ʻole (P ≤ 0.05).ʻO ka helu moku koko makuahine: ka laulā 0-3, kahi hoʻonohonoho o ʻekolu mau hōʻailona binary: ke alo o ka carotid plaque, ka mānoanoa o ka carotid artery intima-media i hoʻoponopono ʻia e ka makahiki a ʻoi aku ma mua o 90% i kā mākou hāpana, a me ka nalu pulse cervical-femoral. ʻoi aku ka wikiwiki ma mua o 90% ua like me ka makahiki a me ke kahe koko maikaʻi loa.iwakāluakumakahi
ʻAʻole pili ka helu makuahine (ICVH, vascular score) a me ka hui pū ʻana o ke keiki a me ka helu makuahine i ka phenotype arterial o nā keiki (Supplementary Table S10).
I loko o kēia kālailai cross-sectional o nā makuahine a me kā lākou mau keiki 6-makahiki, ua noiʻi mākou i ka hui ma waena o ka ICVH kamaliʻi, ka ICVH makuahine, a me ka atherosclerosis subclinical makuahine me ke ʻano a me ka hana o nā aʻa o nā keiki.ʻO ka ʻike nui ʻo ia wale nō ka subclinical atherosclerosis o ka makuahine, ʻoiai ʻaʻole pili nā kumu pilikia cardiovascular maʻamau o nā keiki a me nā makuahine i nā hoʻololi ʻino i nā phenotypes vascular ʻōpiopio.Hoʻonui kēia ʻike hou i ka hoʻomohala ʻana i ka vascular ʻōpiopio i ko mākou ʻike i ka hopena intergenerational o subclinical atherosclerosis.
Hōʻike mākou i nā hōʻike no ka emi ʻana o ka hoʻonui ʻana o ke aʻa carotid a me nā ʻano o ka ʻaʻaʻa carotid beta stiffness a me ka carotid artery IMT i nā keiki o nā makuahine me nā maʻi cardiovascular maʻi vascular substitutes.Eia nō naʻe, ʻaʻohe pilina pololei ma waena o nā hōʻailona hana vascular o ka makuahine a me ka pēpē.Manaʻo mākou ʻo ka hoʻokomo ʻana i ka plaque makuahine i ka helu vascular e hoʻonui nui i kona waiwai wānana.
Ua ʻike mākou i ka pilina maikaʻi ma waena o ke aʻa carotid IMT i nā keiki a me nā makuahine;akā naʻe, ʻaʻole maopopo ka mīkini no ka mea kūʻokoʻa ka carotid artery IMT i nā keiki i nā ʻano o ke keiki a me ka makuahine.ʻO ka hui ma waena o ka helu ICVH o nā keiki a me ka carotid IMT i hōʻike ʻole ʻia, no ka mea, ʻaʻole mākou i ʻike i kekahi ʻokoʻa ma waena o ka ICVH haʻahaʻa a me ka ICVH kiʻekiʻe.
Ua ʻike mākou he mea nui paha nā kumu ʻē aʻe, e like me ke kaʻe o ke poʻo o nā keiki, ʻo ia paha kahi mea wānana nui i ka nui o ke aʻa carotid i ka wā mua o ka ulu ʻana.Eia kekahi, pili paha kā mākou hopena i nā mea i ana ʻole ʻia e pili ana i ka hoʻomohala ʻana o ka fetal vascular.Eia naʻe, ua hōʻike mua mākou ʻaʻohe hopena ma mua o ka hāpai ʻana i ka momona / ka momona a me ka maʻi diabetes gestational i ka carotid IMT.14 Pono nā noiʻi hou aʻe e ʻimi i ka mana o ke ʻano a me ka hana ʻana o ke aʻa i ka ulu ʻana o nā keiki a me ka moʻo.
Ua kūlike nā hui i hōʻike ʻia me nā haʻawina mua i hana ʻia i nā ʻōpio, ka mea i hāʻawi i nā hōʻike o nā hui ma waena o nā phenotypes vascular makua-keiki, me ka carotid IMT, ʻoiai ʻaʻole i hoʻoponopono ʻia ka nui o ke kino i ka nānā ʻana.29 ʻO ka hoʻoilina nui o ka carotid IMT e hōʻoia hou ana i kēia a me ka ʻoʻoleʻa o ke aʻa o nā mākua.30,31
ʻAʻole i hoʻonui ʻia ka hui ʻana ma waena o ka atherosclerosis subclinical makuahine a me ka phenotype vascular ʻōpiopio e ka ICVH makuahine.Kūlike kēia me nā haʻawina mua i wehewehe ʻia ai ka hapa nui o ka hoʻololi ʻana i ka phenotype vascular o nā keiki e nā kumu genetic kūʻokoʻa i nā kumu pilikia cardiovascular maʻamau o nā mākua a me nā keiki.29
Eia kekahi, ʻaʻohe pili o nā loli vascular i ʻike ʻia me ka ICVH kamaliʻi, e hōʻike ana i ka mana nui o ke ʻano genetic background.ʻO ka haʻawina o nā mea kaiapuni e like me ka hoʻololi ʻana me ka makahiki o nā keiki, ʻoiai ua hōʻike ʻia kahi noiʻi nui cross-sectional cohort o nā keiki i piha i ka makahiki 11-12 i kahi hui nui ma waena o ka hana vascular o nā keiki a me ICVH.12