Ideal Cardiovascular Health and Adiposity: Implications in Youth

被引:20
作者
Fyfe-Johnson, Amber L. [1 ,3 ]
Ryder, Justin R. [4 ]
Alonso, Alvaro [6 ]
MacLehose, Richard F. [1 ]
Rudser, Kyle D. [2 ]
Fox, Claudia K. [5 ]
Gross, Amy C. [4 ]
Kelly, Aaron S. [4 ,5 ]
机构
[1] Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA
[2] Univ Minnesota, Sch Publ Hlth, Biostat, Minneapolis, MN USA
[3] Washington State Univ, Coll Med, Seattle, WA USA
[4] Univ Minnesota, Sch Med, Dept Pediat, Minneapolis, MN 55455 USA
[5] Univ Minnesota, Sch Med, Dept Med, Minneapolis, MN 55455 USA
[6] Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA
来源
JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2018年 / 7卷 / 08期
基金
美国国家卫生研究院;
关键词
adolescence; ideal cardiovascular health; obesity; pediatrics; risk factor; BODY-MASS INDEX; SEVERE OBESITY; UNITED-STATES; RISK-FACTORS; SCIENTIFIC STATEMENT; VASCULAR CHANGES; YOUNG FINNS; MIDDLE-AGE; FOLLOW-UP; CHILDHOOD;
D O I
10.1161/JAHA.117.007467
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-The American Heart Association set 2020 Strategic Impact Goals that defined cardiovascular risk factors to be included in the concept of ideal cardiovascular health (ICH). The prevalence of ICH among differing levels of adiposity in youth, especially severe obesity, is uncertain. Methods and Results-The cross-sectional study measured ICH metrics in 300 children and adolescents stratified by adiposity normal weight, overweight/obese, and severely obese. ICH incorporates 7 behavioral and health metrics, and was characterized as poor, intermediate, or ideal. Individual ICH metrics were transformed into standardized sample z-scores; a summary ICH sample z-score was also calculated. Multivariable linear regression models were used to estimate differences in ICH sample z-scores by adiposity status. Of the 300 participants, 113 were classified as having normal weight, 87 as having overweight/obesity, and 100 as having severe obesity (mean age 12.8 years, SD 2.7; 48% female). No participants met the criteria for ICH; 80% of those classified as having normal weight, 81% of those with overweight/obesity, and all of those with severe obesity were in poor cardiovascular health. After multivariable adjustment, those with overweight/obesity (sample z-score: -1.35; 95% confidence interval, 2.3, 1.1) and severe obesity (sample z-score: 1.45; 95% confidence interval, 2.9, 0.92) had lower overall ICH sample z-scores compared with participants with normal weight. Results were similar for individual ICH metrics. Conclusions-Poor cardiovascular health was highly prevalent in youth; ICH sample z-scores increased across levels of adiposity. Youth with obesity, particularly those with severe obesity, remain a rich target for primary prevention efforts.
引用
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页数:12
相关论文
共 59 条
[21]   Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches A Scientific Statement From the American Heart Association [J].
Kelly, Aaron S. ;
Barlow, Sarah E. ;
Rao, Goutham ;
Inge, Thomas H. ;
Hayman, Laura L. ;
Steinberger, Julia ;
Urbina, Elaine M. ;
Ewing, Linda J. ;
Daniels, Stephen R. .
CIRCULATION, 2013, 128 (15) :1689-1712
[22]   Predicting cardiovascular risk in young adulthood from the metabolic syndrome, its component risk factors, and a cluster score in childhood [J].
Kelly, Aaron S. ;
Steinberger, Julia ;
Jacobs, David R., Jr. ;
Hong, Ching-Ping ;
Moran, Antoinette ;
Sinaiko, Alan R. .
INTERNATIONAL JOURNAL OF PEDIATRIC OBESITY, 2011, 6 (2-2) :E283-E289
[23]   Circulating Activated Endothelial Cells in Pediatric Obesity [J].
Kelly, Aaron S. ;
Hebbel, Robert P. ;
Solovey, Anna N. ;
Schwarzenberg, Sarah Jane ;
Metzig, Andrea M. ;
Moran, Antoinette ;
Sinaiko, Alan R. ;
Jacobs, David R., Jr. ;
Steinberger, Julia .
JOURNAL OF PEDIATRICS, 2010, 157 (04) :547-551
[24]   Lifetime body mass index and later atherosclerosis risk in young adults: examining causal links using Mendelian randomization in the Cardiovascular Risk in Young Finns study [J].
Kivimaki, Mika ;
Smith, George Davey ;
Timpson, Nic J. ;
Lawlor, Debbie A. ;
Batty, G. David ;
Kahonen, Mika ;
Juonala, Markus ;
Ronnemaa, Tapani ;
Viikari, Jorma S. A. ;
Lehtimaki, Terho ;
Raitakari, Olli T. .
EUROPEAN HEART JOURNAL, 2008, 29 (20) :2552-2560
[25]  
Kuczmarski RJ., 2000, VITAL HLTH STAT SERI, Viii-x, P1
[26]   Ideal cardiovascular health in childhood-Longitudinal associations with cardiac structure and function: The Special Turku Coronary Risk Factor Intervention Project (STRIP) and the Cardiovascular Risk in Young Finns Study (YFS) [J].
Laitinen, Tomi T. ;
Ruohonen, Saku ;
Juonala, Markus ;
Magnussen, Costan G. ;
Mikkila, Vera ;
Mikola, Hanna ;
Hutri-Kahonen, Nina ;
Laitinen, Tomi ;
Tossavainen, Paivi ;
Jokinen, Eero ;
Niinikoski, Harri ;
Jula, Antti ;
Viikari, Jorma S. A. ;
Ronnemaa, Tapani ;
Raitakari, Olli T. ;
Pahkala, Katja .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2017, 230 :304-309
[27]   Lifetime measures of ideal cardiovascular health and their association with subclinical atherosclerosis: The Cardiovascular Risk in Young Finns Study [J].
Laitinen, Tomi T. ;
Pahkala, Katja ;
Magnussen, Costan G. ;
Oikonen, Mervi ;
Viikari, Jorma S. A. ;
Sabin, Matthew A. ;
Daniels, Stephen R. ;
Heinonen, Olli J. ;
Taittonen, Leena ;
Hartiala, Olli ;
Mikkila, Vera ;
Hutri-Kahonen, Nina ;
Laitinen, Tomi ;
Kahonen, Mika ;
Raitakari, Olli T. ;
Juonala, Markus .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2015, 185 :186-191
[28]   Childhood lifestyle and clinical determinants of adult ideal cardiovascular health. The Cardiovascular Risk in Young Finns Study, the Childhood Determinants of Adult Health Study, the Princeton Follow-up Study [J].
Laitinen, Tomi T. ;
Pahkala, Katja ;
Venn, Alison ;
Woo, Jessica G. ;
Oikonen, Mervi ;
Dwyer, Terence ;
Mikkila, Vera ;
Hutri-Kahonen, Nina ;
Smith, Kylie J. ;
Gall, Seana L. ;
Morrison, John A. ;
Viikari, Jorma S. A. ;
Raitakari, Olli T. ;
Magnussen, Costan G. ;
Juonala, Markus .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2013, 169 (02) :126-132
[29]   Ideal Cardiovascular Health in Childhood and Cardiometabolic Outcomes in Adulthood The Cardiovascular Risk in Young Finns Study [J].
Laitinen, Tomi T. ;
Pahkala, Katja ;
Magnussen, Costan G. ;
Viikari, Jorma S. A. ;
Oikonen, Mervi ;
Taittonen, Leena ;
Mikkila, Vera ;
Jokinen, Eero ;
Hutri-Kahonen, Nina ;
Laitinen, Tomi ;
Kahonen, Mika ;
Lehtimaki, Terho ;
Raitakari, Olli T. ;
Juonala, Markus .
CIRCULATION, 2012, 125 (16) :1971-1978
[30]   Childhood cardiovascular risk factors and carotid vascular changes in adulthood - The Bogalusa Heart Study [J].
Li, SX ;
Chen, W ;
Srinivasan, SR ;
Bond, MG ;
Tang, R ;
Urbina, EM ;
Berenson, GS .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 290 (17) :2271-2276