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Isano iri hagati yubuzima bwiza bwimitsi yumutima na fenotipike yimitsi yababyeyi babyibushye hamwe nabana babo bafite imyaka 6
Abanditsi: 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 Ibitaro bya Taisto Sarkola1,31 Ibitaro bya kaminuza ya Helsinki na Helsinki, Helsinki, Finlande;Ishami ry’indwara z'umutima zavutse hamwe n’umutima w’abana, kaminuza y’ubuvuzi ya Silesiya, Katowice, Polonye, Zabrze FMS;3 Ikigo cy’ubushakashatsi cy’ubuvuzi cya Minerva, Helsinki, Finlande;Ishami ry’ibiribwa nimirire, kaminuza ya Helsinki, Helsinki, Finlande;5LIKES Ibikorwa bya siporo nubushakashatsi bwubuzima, Jyvaskyla, Finlande;6 Ibitaro by’abagore bya kaminuza ya Helsinki n’ibitaro bya kaminuza bya Helsinki i Helsinki, muri Finilande;Ikigo cy’ubushakashatsi cya Folkhälsan, Helsinki, Finlande;8 Kaminuza ya Helsinki na Helsinki Ishami ry’ubuvuzi rusange n’ubuvuzi bw’ibanze, Ibitaro bya Kaminuza, Helsinki, Finlande;9 Porogaramu y’ubushakashatsi bw’abantu ishobora guhinduka n’ishami ry’ububyaza n’umugore, Ishuri ry’Ubuvuzi rya Yang Luling, Kaminuza Nkuru ya Singapore, Singapore;Ikigo cya Singapore Institute of Clinical Science (SICS), Biro y'Ubumenyi, Ikoranabuhanga n'Ubushakashatsi (A & AST; STAR), Itumanaho rya Singapore: Linda Litwin Ishami rishinzwe indwara z'umutima wavukanye umutima ndetse n'indwara z'umutima, Zabrze FMS, kaminuza y’ubuvuzi ya Silesiya, M.Sklodowskiej-Curie 9, Zabrze, 41-800, Polonye Tel +48 322713401 Fax +48 322713401 Imeri ntibisobanutse.Twari tugamije gusuzuma isano iri hagati yubuzima bwiza bwumutima nimiyoboro y'amaraso kubana na ba nyina, atherosclerose ya nyababyeyi, na fenotipi ya arterial mu bana.Uburyo: Duhereye ku bushakashatsi bwo kwirinda indwara ya Diyabete yo muri Finilande (RADIEL) ya longitudinal cohort, isesengura ry’ibice by’abana 201 b’ababyeyi-bana bafite imyaka 6.1 ± 0.5 y’imyaka y'amavuko ryasuzumye ubuzima bwiza bw'umutima n'imitsi (BMI, umuvuduko w'amaraso, glucose yamaraso, cholesterol yuzuye, indyo yuzuye, ibikorwa byumubiri, itabi), ibigize umubiri, karotide ultra-high frequency ultrasound (25 na 35 MHz) n'umuvuduko wa pulse.Ibisubizo: Twasanze nta sano riri hagati yubuzima bwiza bwumutima nimiyoboro yumutima wumwana na nyina, ariko twatanze ibimenyetso byerekana isano iri hagati yibipimo byihariye: cholesterol yuzuye (r = 0.24, P = 0.003), BMI (r = 0.17, P = 0.02), umuvuduko w'amaraso wa Diastolique (r = 0.15, P = 0.03) n'ubwiza bw'imirire (r = 0.22, P = 0.002).Fenotipi y'abana ntaho ihuriye n'ubuzima bwiza bw'umutima n'imitsi y'umwana cyangwa nyina.Muburyo butandukanye bwo gusobanura ibyasubiwemo byahinduwe kuburinganire bwabana, imyaka, umuvuduko wamaraso wa systolique, ubwinshi bwumubiri wumubiri, hamwe nijanisha ryibinure byumubiri, ubunini bwimitsi ya karotide arima intima-itangazamakuru mubana byahujwe gusa nubunini bwububyimba bwimitsi ya karotide yababyeyi. -media (kwiyongera kwa 0.1 mm [95%] CI 0.05, 0.21, P = 0.001] Ubunini bwimitsi ya karotide yababyeyi intima-itangazamakuru yiyongereyeho mm 1).Abana b'ababyeyi bafite aterosklerose ya subclinical yagabanije kwaguka kwa karoti (1.1 ± 0.2 vs 1.2 ± 0.2% / 10 mmHg, P = 0.01) kandi byongera imiyoboro ya karotide intima-itangazamakuru (0.37 ± 0.04 vs 0.35) ± 0.04 mm, P = 006) Umwanzuro: Ibipimo byubuzima bwiza bwumutima nimiyoboro y'amaraso bifitanye isano itandukanye na nyina-umwana bombi mubana bato.Ntabwo twabonye ibimenyetso byerekana ingaruka zubuzima bwiza bwumutima nimiyoboro yimitsi yumutima kumutima kuri fenotipi yabana.Umubyimba wa karotide yumubyimba intima-itangazamakuru irashobora guhanura imitsi ya karotide intima-itangazamakuru mubana, ariko uburyo bwayo bwibanze ntiburasobanuka.Atherosclerose ya nyababyeyi ifitanye isano no gukomera kwa karotide yo mu bwana.Ijambo ryibanze: indwara yumutima nimiyoboro, aterosklerose, karotide arteri intima-itangazamakuru, umubyibuho ukabije, abana
Indwara gakondo z'umutima-damura zishobora kugira uruhare mu kubaho no gutera imbere kwa ateriyose.1,2 Impamvu zishobora guhura na hamwe, kandi guhuza kwabo bisa nkaho bihanura ibyago byumutima nimiyoboro y'amaraso.3
Ishyirahamwe ry’imitima y'Abanyamerika risobanura ubuzima bwiza bw'umutima n'imitsi (ICVH) nk'urutonde rw'ibipimo birindwi by'ubuzima (indangagaciro z'umubiri (BMI), umuvuduko w'amaraso (BP), glucose y'amaraso yiyiriza ubusa, cholesterol yuzuye, indyo yuzuye, ibikorwa by'umubiri, itabi) kugira ngo biteze imbere umwimerere kwirinda Indwara z'umutima n'imitsi mu bana no mu bantu bakuru.4 ICVH ifitanye isano mbi na aterosklerose ya subclinical.5 ICVH hamwe na fenotipike mbi yimitsi ni ibyiringiro byukuri byerekana ibintu byumutima nimiyoboro yimpfu nimpfu zabantu bakuru.6-8
Indwara z'umutima-damura z'ababyeyi zongera ibyago byo kurwara umutima-mitsi mu rubyaro.9 Ibidukikije bijyanye na genetique nubuzima busanzwe byombi bifatwa nkuburyo bushoboka, ariko uruhare rwabo ntiruramenyekana.10,11
Isano riri hagati yumubyeyi numwana ICVH rimaze kugaragara mubana bafite imyaka 11-12.Kuri iki cyiciro, ICVH y'abana ifitanye isano na karotide ya arterique kandi ifitanye isano mbi na cervical femoral pulse wave umuvuduko (PWV), ariko ntigaragarira mumitsi ya karotide intima-itangazamakuru (IMT).12 Nyamara, ibyago byumutima nimiyoboro iri hagati yimyaka 12-18 bifitanye isano no kwiyongera kwa karotide IMT mubuzima bwimyaka yo hagati, kandi ntaho bihuriye nibitera ingaruka mugihe kimwe.13 Ibimenyetso byerekeranye n'imbaraga z'aya mashyirahamwe akiri muto birabuze.
Mubikorwa byacu byabanje, ntitwabonye ingaruka za diyabete yibise cyangwa ibikorwa byubuzima bwababyeyi kuri antropometrie yo mu bwana, imiterere yumubiri cyangwa ingano yimikorere.14 Ibyibandwaho muri iri sesengura ni uburyo bwo guhuza ibisekuruza byerekana ingaruka z'umutima.Icyiciro n'ingaruka zacyo kuri arterial phenotype yabana.Turakekeranya ko ICVH y'ababyeyi n'abasimbura imitsi y'indwara z'umutima-damura bizagaragarira mu bwana ICVH na fenotipi ya arterial mu bwana.
Ibice byambukiranya ibice biva mu myaka itandatu ikurikiranwa n’ubushakashatsi bwo kwirinda indwara ya Diyabete yo muri Finilande (RADIEL).Igishushanyo mbonera cyubushakashatsi cyatanzwe ahandi.15 Muri make, abagore bateganya gusama cyangwa bari mu gice cya mbere cyo gutwita kandi bafite ibyago byinshi byo kurwara diyabete yo mu nda (umubyibuho ukabije / cyangwa amateka ya diyabete yo mu nda) (N = 728).Imyaka 6 ikurikiranwa ryumutima nimiyoboro yimitsi yateguwe nkubushakashatsi bwo kureba ku babyeyi-impinja zombi, hamwe n’umubare ungana w’ababyeyi barwaye diyabete yo mu nda kandi badafite, bafite ubunini bwateganijwe mbere (~ 200).Kuva muri Kamena 2015 kugeza Gicurasi 2017, ubutumire bukomeje koherezwa kubitabiriye amahugurwa kugeza igihe ntarengwa kigeze, kandi hashakishijwe 201 joriji ebyiri.Ikurikiranabikorwa ryateguwe ku bana bafite hagati y’imyaka 5-6 kugira ngo habeho ubufatanye nta gutuza, harimo isuzuma ry’amatsinda abiri y’ababyeyi n’ababyeyi gusuzuma ingano y’umubiri n’ibigize, umuvuduko wamaraso, kwiyiriza ubusa glucose yamaraso na lipide yamaraso, imyitozo ngororamubiri ukoresheje umuvuduko wa moteri, ubwiza bwimirire na kunywa itabi (ababyeyi), imiyoboro y'amaraso Ultrasound hamwe no gupima umuvuduko w'amaraso hamwe na echocardiografiya mubana.Kuboneka kwamakuru kurutonde rwinyongera S1.Komite ishinzwe imyitwarire y’ububyaza n’umugore, ubuvuzi bw’abana n’indwara zo mu mutwe z’ibitaro bya kaminuza ya Helsinki yemeje protocole y’ubushakashatsi (20/13/03/03/2015) kugira ngo hasuzumwe imyaka itandatu.Ababyeyi bose babimenyeshejwe inyandiko yabonetse mugihe cyo kwiyandikisha.Ubushakashatsi bwakozwe hakurikijwe Itangazo rya Helsinki.
Umushakashatsi kabuhariwe (TS) akoresha transducers 25 MHz na 35 MHz hamwe na sisitemu ya Vevo 770, kandi akoresha UHF22, UHF48 (inshuro zisa hagati) hamwe na sisitemu ya Vevo MD (VisualSonics, Toronto, Kanada) nkibice 52 byanyuma byababyeyi numwana.Imiyoboro isanzwe ya karotide yashushanijwe kuri cm 1 yegeranye n’ibice byombi bya karotide, kandi umwanya wo kuruhukira wari mu mwanya wa supine.Koresha inshuro ndende zishobora kwiyumvisha urukuta rwa kure kugirango ubone amashusho meza ya firime yuzuye 3-4 yumutima.Koresha Vevo 3.0.0 (Vevo 770) ukoresheje intoki za elegitoronike hamwe na software ya VevoLab (Vevo MD) kugirango usesengure amashusho kumurongo.16 Lumen diameter na IMT byapimwe nindorerezi inararibonye (JKMS) kumpera ya diastole ikoresheje tekinoroji igezweho), itazi ibiranga ibintu (Ishusho yinyongera S1).Twabanje kuvuga ko coefficente yimbere-indorerezi ihindagurika yapimwe na ultras-ultras-ultrases ultrases mu bana no ku bantu bakuru ni 1,2-3.7% muri diameter ya lumen, IMT ni 6.9-9.8%, naho coefficient de la indorerezi ni itandukaniro. 1.5-4,6% muri diameter ya lumen., 6.0-10.4% ya IMT.Amanota ya karotide IMT Z yahinduwe kumyaka nuburinganire yabazwe hifashishijwe ibyerekeranye nabana bera bazima badafite umubyibuho ukabije.17
Diameter ya Carotide yapimwe kuri pex systole na end-diastole kugirango isuzume imiyoboro ya karotide index indangagaciro zikomeye hamwe na coefficient yo kwagura imiyoboro ya karoti.Hifashishijwe cuff ifite ubunini bukwiye, uburyo bwa oscillometricique (Dinamap ProCare 200, GE) bwakoreshejwe mukwandika umuvuduko wamaraso wa systolique na diastolique kugirango ubare imikorere ya elastique mugihe cyo gufata amashusho ya ultrasound muburyo bwiza bwikiganza cyiburyo.Coefficient yo kwagura imiyoboro ya karotide hamwe nimiyoboro ya karotide index -gukomera kubarwa uhereye kumitsi ya karoti ukoresheje formula ikurikira:
Muri byo, CCALAS na CCALAD nibisanzwe bya karotide arteri lumen mugihe cya systole na diastole;CCALDS na CCALDD nibisanzwe bya karotide artery lumen diameter mugihe cya systole na diastole;SBP na DBP ni umuvuduko w'amaraso wa sisitemu na diastolique.18 Coefficient de variaux de la coiffe de la carotide yo kwaguka mu ndorerezi ni 5.4%, coefficente yo guhinduranya imiyoboro ya karotide index indangagaciro zikomeye ni 5.9%, naho coefficient hagati y-indorerezi yo guhinduranya kwaguka kwimitsi ya karoti ni 11,9%. na 12.8% ya karoti arteri index indangagaciro.
Imikorere gakondo ya ultrasound Vivid 7 (GE) ifite transducer ya 12 MHz yakoreshejwe kugirango irusheho kwerekana imiyoboro y'amaraso ya nyababyeyi kuri plaque.Guhera kumitsi isanzwe ya karotide hafi yigitereko, imiyoboro ya karotide isuzumwa muburyo bubiri binyuze mumacakubiri hamwe nigice cyegeranye cyimitsi yimbere ninyuma.Ukurikije ubwumvikane bwa Mannheim, icyapa gisobanurwa nka 1. Kwiyongera kwurukuta rwubwato kuri mm 0,5 cyangwa 50% bya IMT ikikije cyangwa 2. Uburebure bwurukuta rwa arterial burenga mm 1.5.Kuba hari icyapa cyasuzumwe na dicotomy.Indorerezi y'ibanze (JKMS) yigenga ikora ibipimo byisubiramo ku gice cy'amashusho (N = 40) kugira ngo isuzume itandukaniro riri hagati y’indorerezi, naho indorerezi ya kabiri (TS) isuzuma itandukaniro ry’indorerezi.Cohen κ yimiterere-yindorerezi nimpinduka-indorerezi ni 0.89 na 0.83.
PWV yapimwe n'umuforomokazi w’ubushakashatsi wahuguwe kugira ngo asuzume ubukana bwa arterial yo mu karere akoresheje sensor ya mashini (Complior Analyse, Alam Medical, Saint-Quentin-Fallavier, Ubufaransa) igihe yaruhukiye mu mwanya wa supine.20 Sensor zishyirwa kumitsi ya karoti iburyo, imiyoboro iburyo ya radiyo, hamwe nimiyoboro iburyo ya femorale kugirango isuzume hagati (iburyo bwa karotide arteri-femorale arteriire) hamwe na peripheri (iburyo bwa karotide arteri-radial arteriire).Koresha kaseti kugirango upime intera itaziguye hagati yo gufata amajwi kugera kuri cm 0.1 hafi.Intera iburyo ya karotide femorale artera yikubye 0.8 hanyuma ikoreshwa mukubara hagati PWV.Subiramo amajwi mumwanya wa supine.Inyandiko ebyiri zabonetse mugihe inyandiko ya gatatu yakorwaga mugihe itandukaniro riri hagati yipima ryarenze 0.5 m / s (10%).Mugushiraho ibipimo birenga bibiri, ibisubizo hamwe nigiciro gito cyo kwihanganira bikoreshwa mubisesengura.Ubworoherane ni ikintu cyiza kigereranya itandukaniro rya pulse mugihe cyo gufata amajwi.Koresha impuzandengo byibura ibipimo bibiri mubisesengura ryanyuma.PWV y'abana 168 irashobora gupimwa.Coefficient yo gutandukanya ibipimo byasubiwemo yari 3.5% kuri arteri-karoti-femorale PWV na 4.8% kuri karotide-radial arteri PWV (N = 55).
Urutonde rwibipimo bitatu byifashishwa mu kwerekana umubyibuho ukabije wa nyina: kuba hari plaque arterique plaque, karotide arteri IMT yahinduye imyaka kandi irenga 90 ku ijana murugero rwacu, kandi hejuru ya 90% PWV y ijosi nigitsina gore irahuye hamwe n'imyaka n'umuvuduko ukabije w'amaraso.makumyabiri na rimwe
ICVH ni urutonde rwibipimo 7 byerekana ibipimo byegeranye kuva kuri 0 kugeza kuri 7 (uko amanota ari hejuru, niko ahuza nubuyobozi).4 Ibipimo bya ICVH bikoreshwa muri ubu bushakashatsi bihuye n’ibisobanuro byumwimerere (byahinduwe bitatu) -Imbonerahamwe y'inyongera S2) kandi ikubiyemo:
Ubwiza bwimirire busuzumwa nu mwana wo muri Finilande w’ubuzima bwiza bwo kurya (intera 1-42) hamwe n’ibipimo by’ibiribwa by’umubyeyi (intera 0-17).Ibipimo byombi bikubiyemo ibyiciro 4 kuri 5 byashyizwe mubipimo byimirire yumwimerere (usibye gufata sodium).23,24 Agaciro kingenzi keza keza keza kandi kadakwiriye gusobanurwa nka 60% cyangwa arenga kugirango agaragaze ubwiza bwimirire yumwimerere.Ibisobanuro byerekana (nibyiza niba birenze 3 kuri 5 byujujwe).Ku bijyanye n’abana baherutse kuvura ubuzima bw’abana bo muri Finilande (87.7% ku bakobwa, 78.2% ku bahungu), niba umubare w’uburinganire bw’abana barengeje urugero, BMI y’umwana isobanurwa ko idakwiye, itandukanye gato na 85 % by'abaturage ba Finilande.22 Bitewe numubare munini wabata ishuri hamwe nagaciro gake cyane kavangura (Imbonerahamwe yinyongera S1, 96% byababyeyi bujuje ibisabwa na ICVH), ibikorwa byumubiri byabagore batwite nabaryamye barashizwemo.ICVH igabanijwemo ibyiciro bikurikira: hasi (abana 0-3, ba nyina 0-2), hagati (abana 4, ababyeyi 3-4) na hejuru (abana na ba nyina 5-6), bitanga amahirwe yo kugereranya ibyiciro bitandukanye .
Koresha ibikoresho bya elegitoronike (Seca GmbH & Co KG, Ubudage) gupima uburebure n'uburemere kuri cm 0.1 hafi na 0.1 kg.Amanota ya BMI Z y'abana atangwa hifashishijwe amakuru aheruka gutangwa muri Finlande.22 Ibigize umubiri byatsinze bioelectrical impedance isuzuma (InBody 720, InBody Bldg, Koreya yepfo).
Umuvuduko wamaraso uruhuka wapimwe nuburyo bwa oscillometric uhereye kumaboko yi buryo wicaye (Omron M6W, Omron Healthcare Europe BV, Ubuholandi) hamwe na cuff ihagije.Impuzandengo yumuvuduko wamaraso wa systolique na diastolique ubarwa uhereye kubipimo bibiri byo hasi (byibuze ibipimo bitatu).Umuvuduko wamaraso wabana Z agaciro kabarwa ukurikije amabwiriza.25
Amaraso ya plasma glucose na lipide yakusanyirijwe mugihe cyo kwiyiriza ubusa.Ibisubizo byatanzwe ku bana 3 bubahiriza kwiyiriza ubusa (triglyceride ikabije, glucose yamaraso yisonzesha, hamwe na glycosylated hemoglobine A1c (HbA1c)) ntibyakuwe mubisesengura.Cholesterol yuzuye, lipoprotein nkeya (LDL) cholesterol, cholesterol ya lipoprotein (HDL) ya cholesterol na triglyceride igenwa nuburyo bwa enzymatique, plasma glucose na enzyme ya hexokinase, hamwe na HbA1c hamwe nisesengura rya immunoturbidimetric (Roche Diagnostics, Basel, Busuwisi) kugirango bisuzumwe. .
Ifunguro ry’imirire y’ababyeyi ryasuzumwe n’ibibazo by’inshuro y’ibiribwa kandi bisuzumwa n’ibipimo bifatika by’ibiribwa.Ironderero ryibiryo byubuzima bwiza ryemejwe mbere nkigikoresho cyingirakamaro kigaragaza kubahiriza ibyifuzo byimirire ya Nordic 26 muri cohort yambere ya RADIEL.24 Muri make, ikubiyemo ibintu 11, bikubiyemo kurya imboga, imbuto n'imbuto, ibinyamisogwe byinshi, amafi, amata, foromaje, amavuta yo guteka, isosi y'amavuta, udukoryo, ibinyobwa birimo isukari n'ibiryo byihuse.Iyo amanota menshi yerekana urwego rwo hejuru rwo kubahiriza ibyifuzo.Ubwiza bwimirire yabana bwasuzumwe hifashishijwe ibiryo byiminsi 3 kandi bisuzumwa nubushakashatsi bw’abana bafite ubuzima bwiza muri Finilande.Ironderero ry’abana bafite ubuzima bwiza muri Finilande ryemejwe mbere mu baturage b’abana bo muri Finilande.23 Harimo ubwoko butanu bwibiryo: imboga, imbuto n'imbuto;amavuta na margarine;ibiryo birimo isukari nyinshi;amafi n'amafi n'imboga;n'amata asukuye.Ibiryo byokurya byatsinzwe kuburyo uko ukoresha byinshi, niko amanota menshi.Usibye ibiryo birimo isukari nyinshi, amanota arahindurwa.Mbere yo gutanga amanota, hindura gufata imbaraga mugabanye gufata (garama) ukoresheje ingufu (kcal).Iyo amanota ari hejuru, niko ireme ryimirire yabana.
Hagati yimyitozo ngororamubiri ikomeye (MVPA) yapimwe hifashishijwe ikibero cyihuta cyumwana (ActiGraph GT3X, ActiGraph, Pensacola, USA) hamwe n ukuboko kwababyeyi (SenseWear ArmBand Pro 3).Amabwiriza yo kwambara monite mugihe cyo gukanguka no gusinzira, ariko igihe cyo gusinzira nticyakuwe mubisesengura.Umugenzuzi wabana akusanya amakuru ku gipimo cya 30 Hz.Ubusanzwe amakuru arayungurura, ahindurwa mumasegonda 10-amasegonda, hanyuma asesengurwa hifashishijwe ingingo ya Evenson (2008) yaciwe (≥2296 cpm).27 Umugenzuzi wa nyina akusanya MET indangagaciro mugihe cyamasegonda 60.MVPA ibarwa nkuko MET ifite agaciro karenze 3. Ibipimo bifatika bisobanurwa byibuze iminsi 2 yakazi na wikendi 1 (kwandika byibuze iminota 480 kumunsi) niminsi 3 yakazi na wikendi 1 (kwandika byibuze iminota 720 kumunsi) kuri nyina.Igihe cya MVPA kibarwa nkimpuzandengo iremereye [(impuzandengo ya MVPA iminota / kumunsi kumunsi wicyumweru × 5 + impuzandengo ya MVPA iminota / umunsi muri wikendi × 2) / 7], wongeyeho, nkijanisha ryigihe cyo kwambara.Ibikorwa byimikorere byimikorere yabaturage ba Finlande byakoreshejwe nkibisobanuro.28
Ikibazo cyakoreshejwe kugirango haboneke amakuru ajyanye no kunywa itabi rya nyina, indwara zidakira, imiti, n'uburere.
Ibyatanzwe bisobanurwa nkibisobanuro ± SD, hagati (intera intera intera) cyangwa kubara (ijanisha).Suzuma ikwirakwizwa risanzwe ryibihinduka byose bishingiye kuri histogramu na QQ isanzwe.
Ikizamini cyigenga cyigenga, Ikizamini cya Mann-Whitney U, isesengura ryuburyo bumwe butandukanye, Kruskal-Wallis, hamwe na chi-kare ikizamini cyakoreshejwe nkibikwiye mu matsinda yo kugereranya (nyina n'umwana, umuhungu n'umukobwa, cyangwa ICVH yo hasi kandi yo hagati na hejuru ).
Coefficient ya Pearson cyangwa Spearman yakoreshejwe mugushakisha ishyirahamwe ritandukanye hagati yimiterere yumwana na nyina.
Uburyo butandukanye bwo gusubira inyuma bwakoreshejwe mugushiraho uburyo bwo gusobanura abana ba cholesterol ya HDL na karotide IMT.Guhitamo guhinduka gushingiye kubihuza nubuhanga bwamavuriro yubuhanga, birinda ibintu byinshi muburyo butandukanye, kandi bikubiyemo ibintu bishobora gutera urujijo.Multicollinearity isuzumwa hifashishijwe impinduka ziterwa nifaranga, hamwe nagaciro ntarengwa 1.9.Kwisubiraho kwinshi kwakoreshejwe mu gusesengura imikoranire.
Imirizo ibiri P ≤ 0.05 yashyizweho kugirango ibe ingirakamaro, usibye mu isesengura rifitanye isano n’imiterere y’imitsi ya karoti IMT ku bana bafite P ≤ 0.01.
Ibiranga abitabiriye amahugurwa bigaragara mu mbonerahamwe ya 1 nimbonerahamwe yinyongera S3.Ugereranije n’abaturage bavugwa, amanota ya BMI Z y'abana na BP Z yiyongereye.Ibikorwa byacu byabanje byatanze amakuru arambuye kuri arterial morphologie mubana.14 Abana 15 (12%) gusa na ba nyina 5 (2.7%) bujuje ibyangombwa byose bya ICVH (Ishusho yinyongera 2 na 3, Imbonerahamwe yinyongera S4-S6).
Amanota y'ababyeyi n'impinja ICVH ifitanye isano gusa n'abahungu (abahungu: rs = 0.32, P = 0.01; abakobwa: rs = -0.18, P = 0.2).Iyo usesenguye nkibihinduka bikomeza, isesengura rifitanye isano rya nyababyeyi-impinja rifite akamaro gakomeye mugupima lipide yamaraso, HbA1C, umubyibuho ukabije, umuvuduko wamaraso wa diastolique, hamwe nubwiza bwimirire (Imibare yinyongera S4-S10).
LDL y'abana na nyina LDL, HDL, hamwe na cholesterol yose bifitanye isano (r = 0.23, P = 0.003; r = 0.35, P <0.0001; r = 0.24, P = 0.003, Ishusho 1).Iyo ukurikije igitsina cy'umwana, isano iri hagati ya LDL y'umwana na nyina na cholesterol yuzuye yagumye kuba iy'abahungu gusa (Imbonerahamwe y'inyongera S7).Triglyceride na cholesterol ya HDL bifitanye isano nijanisha ryibinure byumubiri wumukobwa (rs = 0.34, P = 0.004; r = -0.37, P = 0.002, ishusho ya 1, Imbonerahamwe yinyongera S8).
Igicapo 1 Isano iri hagati yamaraso yumwana na nyina.Gutatanya umugambi hamwe n'umurongo wo gusubira inyuma (95% intera y'icyizere);(AC) urugero rw'amaraso ya nyina n'ababyeyi;(D) ibinure byumubiri wumukobwa hamwe na cholesterol ya lipoprotein yuzuye.Ibisubizo byingenzi byerekanwe mubutinyutsi (P ≤ 0.05).
Amagambo ahinnye: LDL, lipoprotein nkeya;HDL, lipoprotein yuzuye cyane;r, Coefficient ya Pearson.
Twasanze hari isano rikomeye hagati ya HbA1C yumwana na nyina (r = 0.27, P = 0.004), ariko ntabwo byari bifitanye isano no kwiyiriza ubusa glucose yamaraso (P = 0.4).Amanota ya BMI Z y'abana, ariko ntabwo ari ijanisha ryibinure byumubiri, ntaho ahuriye cyane na BMI ya nyina hamwe nigipimo cyikibuno (r = 0.17, P = 0.02; r = 0.18, P = 0.02).Agaciro Z k'umuvuduko w'amaraso wa diastolique y'abana ntaho gahuriye n'umuvuduko w'amaraso wa nyina wa diastolique (r = 0.15, P = 0.03).Indanganturo yimirire myiza yabana bo muri Finilande ifitanye isano nigipimo cyiza cyo gufata ibiryo bya nyina (r = 0.22, P 0.002).Iyi sano yagaragaye gusa mubahungu (r = 0.31, P = 0.001).
Nyuma yo gukuramo ababyeyi bavuwe na hypertension, hypercholesterolemia, cyangwa hyperglycemia, ibisubizo byari bihamye.
Ibisobanuro birambuye bya arterial bigaragara mu mbonerahamwe ya S9.Imiterere y'amaraso y'abana ntabwo yigenga kubiranga abana (Imbonerahamwe yinyongera S10).Ntabwo twarebye isano iri hagati yubwana ICVH nuburyo bwimitsi cyangwa imikorere.Mu isesengura ry’abana batandukanijwe n’amanota ya ICVH, twabonye ko amanota ya karotide IMT Z y’abana bafite amanota make gusa yiyongereye ugereranije n’abana bafite amanota make (bivuze ± SD; amanota aringaniye 0.41 ± 0.63 vs amanota make- 0.07 ± 0.71, P = 0.03, Imbonerahamwe yinyongera S11).
Umubyeyi ICVH ntaho ahuriye na fenotipike yimitsi yabana (Imbonerahamwe yinyongera S10 na S12).Abana na karotide arteri arteri IMT irafitanye isano (Igicapo 2), ariko isano iri hagati yumubyeyi n’umwana hagati yimiterere itandukanye yimitsi iva mu mitsi ntabwo ihambaye mu mibare (Imbonerahamwe 9, Umugereka S11).Muburyo butandukanye bwo gusobanura ibyasubiwemo byahinduwe kuburinganire bwabana, imyaka, umuvuduko wamaraso wa systolike, ubwinshi bwumubiri, hamwe nijanisha ryibinure byumubiri, karotide ya nyababyeyi IMT niyo yonyine yigenga ya karotide y'abana IMT (yahinduwe R2 = 0.08).Kuri buri mm 1 kwiyongera kwa karotide yababyeyi IMT, karotide yo mu bwana IMT yiyongereyeho 0.1 mm (95% CI 0.05, 0.21, P = 0.001) (Imbonerahamwe yinyongera S13).Igitsina cy'umwana nticyagabanije izi ngaruka.
Igishushanyo 2 Isano riri hagati yimitsi ya karoti intima-itangazamakuru mubana na ba nyina.Gutatanya umugambi hamwe n'umurongo wo gusubira inyuma (95% intera y'icyizere);.Ibisubizo byingenzi byerekanwe mubutinyutsi (P ≤ 0.05).
Amanota y'amaraso y'ababyeyi afitanye isano na coefficente yo kwagura imiyoboro ya karotide na index gukomera mu bana (rs = -0.21, P = 0.007, rs = 0.16, P = 0.04, Imbonerahamwe y'inyongera S10).Abana bavutse kubabyeyi bafite amanota yimitsi ya 1-3 bafite coefficient yo hasi yo kwaguka kwimitsi ya karotide ugereranije nabavutse kubabyeyi bafite amanota 0 (bivuze dev gutandukana bisanzwe, 1.1 ± 0.2 vs 1.2 ± 0.2% / 10 mmHg, P = 0.01) kandi hariho imyumvire yo kongera imiyoboro ya karoti β gukomera (median (IQR), 3.0 (0.7) na 2.8 (0.7), P = 0.052) hamwe na karoti arteri IMT (bivuze ± SD, 0.37 ± 0.04 na 0.35 ± 0.04 mm, P = 0.06) (Ishusho 3), Imbonerahamwe y'inyongera S14).
Igishushanyo cya 3 Fenotipi yumwana itondekanya amanota yababyeyi.Ibyatanzwe bigaragazwa nkibisobanuro + SD, P hamwe nicyitegererezo cyigenga (A na C) na Mann-Whitney U ikizamini (B).Ibisubizo byingenzi byerekanwe mubutinyutsi (P ≤ 0.05).Amanota y'amaraso y'ababyeyi: intera 0-3, urutonde rwibipimo bitatu: kuba hari icyapa cya karotide, umubyimba wamaraso ya karotide intima-itangazamakuru ryahinduwe nimyaka kandi rirenga 90% murugero rwacu, hamwe na cervical-femoral pulse wave umuvuduko urenze 90% bihuye n'imyaka kandi umuvuduko w'amaraso mwiza.makumyabiri na rimwe
Amanota y'ababyeyi (ICVH, amanota y'amaraso) hamwe no guhuza amanota y'abana n'ababyeyi ntabwo bifitanye isano na arterial phenotype y'abana (Imbonerahamwe y'inyongera S10).
Muri iri sesengura ry’ibice by’ababyeyi n’abana babo bafite imyaka 6, twasesenguye isano iri hagati y’abana bato ICVH, ICVH y’ababyeyi, na atherosklerose y’ababyeyi bafite imiterere n'imikorere y'imitsi y'abana.Icyagaragaye nyamukuru ni uko gusa umubyibuho ukabije wa nyina wa Atherosclerose, mu gihe abana na ba nyina basanzwe bafite ingaruka z'umutima n'imitsi ntaho bihuriye n'impinduka mbi ziterwa na fenotipike yo mu bwana.Ubu bushishozi bushya bwiterambere ryimitsi yo mumwana akiri muto byongera gusobanukirwa ningaruka zikomoka kumasemburo ya aterosklerose.
Turatanga ibimenyetso byerekana ko kugabanuka kwimitsi ya karoti no kugabanuka kwimitsi ya karotide beta gukomera hamwe na karotide arteri IMT mubana bababyeyi bafite uburwayi bwumutima nimiyoboro y'amaraso.Ariko, nta sano ritaziguye riri hagati yimikorere yimitsi yababyeyi nimpinja.Turakekeranya ko gushyiramo icyapa cyababyeyi mumanota yimitsi yongerera cyane agaciro kayo.
Twabonye isano iri hagati yimitsi ya karotide IMT mubana na ba nyina;icyakora, uburyo buracyasobanutse neza kuko imiyoboro ya karotide IMT mubana itigenga kubiranga umwana na nyina.Ihuriro riri hagati y amanota ya ICVH yabana na karotide IMT ryerekanaga ukudahuza, kuko tutabonye itandukaniro riri hagati ya ICVH nkeya na ICVH ndende.
Turabizi ko ibindi bintu bishobora kugira uruhare, harimo kuzenguruka umutwe wabana, bishobora kuba bihanura ubunini bwimitsi ya karoti mugihe cyambere cyo gukura.Byongeye kandi, ibisubizo byacu birashobora guterwa nibintu bitapimwe bigira ingaruka kumikurire yimitsi.Ariko, twabanje kuvuga ko mbere yo gutwita umubyibuho ukabije / umubyibuho ukabije na diyabete yo mu nda nta ngaruka bigira kuri karotide IMT yo mu bwana.14 Ubundi bushakashatsi burakenewe kugirango hamenyekane ingaruka zimiterere yimitsi n'imikorere kumikurire yabana.
Amashyirahamwe yatangajwe ahuza nubushakashatsi bwibanze bwakozwe mu ngimbi, bwatanze ibimenyetso byerekana isano iri hagati yimitsi yimitsi yababyeyi-umwana, harimo na karotide IMT, nubwo ingano yumubiri itigeze ihinduka mubisesengura.29 Umurage utari muto wa karotide IMT irashimangira kandi gukomera kwa arterial.30.31
Ihuriro ryagaragaye hagati ya atherosclerose ya nyababyeyi na fenotipike yo mu bwana ntabwo ryongerewe na ICVH y'ababyeyi.Ibi bihuye nubushakashatsi bwibanze aho igice kinini cyihindagurika ryimiterere yimitsi yimitsi yabana isobanurwa nimpamvu zishingiye ku ngirabuzima fatizo zidashingiye ku mpamvu zisanzwe ziterwa n’umutima n’umutima by’ababyeyi n’abana.29
Byongeye kandi, impinduka zamaraso zagaragaye ntaho zihuriye na ICVH yo mu bwana, byerekana ingaruka nyamukuru yimiterere yabana bato.Uruhare rwibidukikije rusa nkaho rugenda ruhinduka hamwe n’imyaka y’abana, kubera ko ubushakashatsi bwakozwe mbere y’ubushakashatsi bwakozwe ku bana bafite hagati y’imyaka 11-12 bwerekanye isano iri hagati yimikorere yimitsi y'abana na ICVH.12
Igihe cyo kohereza: Nyakanga-14-2021