Kamano pakeng tsa bophelo bo botle ba pelo le vascular phenotype

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Kamano pakeng tsa bophelo bo botle ba pelo le vascular phenotype ea bo-'mè ba batenya le bana ba bona ba lilemo li 6
Bangoli: 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 Univesithi ea Helsinki le Lipetlele tsa Univesithi ea Helsinki, Helsinki, Finland;2 Lefapha la Congenital Heart Defects le Pediatric Cardiology, Silesian Medical University, Katowice, Poland, Zabrze FMS;3 Setsi sa Lipatlisiso sa Bongaka sa Minerva Foundation, Helsinki, Finland;4 Lefapha la Lijo le Phepo, Univesithi ea Helsinki, Helsinki, Finland;5LIKES Setsi sa Lipapali le Lipatlisiso tsa Bophelo bo Botle, Jyvaskyla, Finland;6 Sepetlele sa Basali sa Univesithi ea Helsinki le Sepetlele sa Univesithi ea Helsinki se Helsinki, Finland;7 Setsi sa Lipatlisiso sa Folkhälsan, Helsinki, Finland;8 Univesithi ea Helsinki le Helsinki Lefapha la Boikoetliso bo Akaretsang le Tlhokomelo ea Bophelo bo Botle ba Pele, Sepetlele sa Univesithi, Helsinki, Finland;9 Lenaneo la Lipatlisiso tsa Phetoho ea Batho le Lefapha la Bokhachane le Botho, Sekolo sa Bongaka sa Yang Luling, Univesithi ea Sechaba ea Singapore, Singapore;10 Singapore Institute of Clinical Sciences (SICS), Science, Technology le Research Bureau (A* STAR), Singapore Communications: Linda Litwin Lefapha la Congenital Heart Defects le Pediatric Cardiology, Zabrze FMS, Silesian Medical University, M.Sklodowskiej-Curie 9, Zabrze, 41-800, Poland Tel +48 322713401 Fax +48 322713401 Email [email protected] Background: Liphatsa tsa lefutso le mekhoa ea bophelo e arolelanoang ka malapa li ka baka likotsi tsa pelo, empa tekanyo eo li amang sebopeho le tšebetso ea methapo ea mali bongoaneng ke e sa hlakang.Re ne re ikemiselitse ho lekola kamano pakeng tsa bophelo bo botle ba pelo le methapo ea pelo ho bana le bo-'m'a, lefu la atherosclerosis la maternal subclinical, le arterial phenotypes baneng.Mekhoa: Ho tsoa ho Finnish Gestational Diabetes Prevention Study (RADIEL) longitudinal cohort, tlhahlobo e fapaneng ea bana ba 201 ba bana ba lilemo tse 6.1 ± 0.5 lilemo li lekotsoe bophelo bo botle ba pelo (BMI, khatello ea mali, tsoekere e potlakileng ea mali, cholesterol eohle, boleng ba lijo, Boikoetliso ba 'mele, ho tsuba), sebopeho sa' mele, carotid ultra-high frequency ultrasound (25 le 35 MHz) le pulse wave velocity.Results: Re fumane hore ho ne ho se na kamano pakeng tsa bophelo bo botle ba pelo le methapo ea ngoana le 'm'a, empa re tlalehile bopaki ba kamano ea matšoao a khethehileng: kakaretso ea k'holeseterole (r=0.24, P=0.003), BMI (r=0.17, P =0.02), khatello ea mali ea diastolic (r=0.15, P=0.03) le boleng ba lijo (r=0.22, P=0.002).Matšoao a arterial phenotype ha a amane le bophelo bo botle ba pelo ea ngoana kapa 'm'a.Moetsong oa toloko e mengata e fetotsoeng bakeng sa bong ba bana, lilemo, khatello ea mali ea systolic, boima ba 'mele o mosesaane le liperesente tsa mafura a' mele, botenya ba artery ea carotid intima-media ho bana bo ne bo amana feela ka boikemelo le botenya ba methapo ea methapo ea carotid intima. -media (keketseho ea 0.1 mm [95 %] CI 0.05, 0.21, P = 0.001] Botenya ba methapo ea carotid ea 'mè oa intima-media bo eketsehile ka 1 mm).Bana ba bo-'mè ba nang le subclinical atherosclerosis ba fokotsehile ho fokotseha ha methapo ea carotid (1.1 ± 0.2 vs 1.2 ± 0.2% / 10 mmHg, P = 0.01) le ho eketseha ha methapo ea carotid intima-media botenya (0.37 ± 0.04 vs 0.35) ± 0.06 mm) ± 0.06 mm) Qetello: Matšoao a nepahetseng a bophelo bo botle ba pelo le methapo a amana ka tsela e fapaneng le lipara tsa 'm'e le ngoana bongoaneng.Ha rea ​​fumana bopaki ba phello ea bophelo bo botle ba pelo le methapo ea bana kapa bo-mme ho bana ba arterial phenotypes.Botenya ba artery ea carotid intima-media bo ka bolela botenya ba methapo ea carotid intima-media ho bana, empa mokhoa oa eona o ntse o sa hlaka.Maternal subclinical atherosclerosis e amana le ho satalla ha methapo ea carotid bongoaneng.Mantsoe a bohlokoa: lefu la pelo, atherosclerosis, botenya ba methapo ea methapo ea carotid, mabaka a kotsi, bana.
Lintho tse tloaelehileng tsa kotsi ea pelo le methapo li kenya letsoho ketsahalong le nts'etsopele ea atherosclerosis.1,2 Lintho tsa kotsi li atisa ho kopana hammoho, 'me ho kopana ha tsona ho bonahala e le ho bolela esale pele kotsi ea pelo ea motho ka mong.3
American Heart Association e hlalosa bophelo bo botle ba pelo (ICVH) e le lethathamo la matšoao a supileng a bophelo bo botle ('mele oa boima ba' mele (BMI), khatello ea mali (BP), tsoekere e potlakileng ea mali, k'holeseterole eohle, boleng ba lijo, boikoetliso ba 'mele, ho tsuba) ho khothalletsa batho ba khale. thibelo Lefu la pelo ho bana le batho ba baholo.4 ICVH e amana hampe le subclinical atherosclerosis ho batho ba baholo.5 ICVH le li-phenotypes tse mpe tsa vascular ke li-predictors tse ka tšeptjoang tsa liketsahalo tsa pelo le lefu ho batho ba baholo.6-8
Lefu la pelo le methapo ea batsoali le eketsa kotsi ea liketsahalo tsa pelo ho bana.9 Lintlha tsa tikoloho tse amanang le liphatsa tsa lefutso le mekhoa e tloaelehileng ea bophelo ka bobeli li nkoa e le mekhoa e ka khonehang, empa tlatsetso ea bona ha e e-s'o tsejoe.10,11
Kamano pakeng tsa motsoali le ngoana ICVH e se e ntse e bonahala ho bana ba lilemo tse 11-12.Mothating ona, ICVH ea bana e amana le elasticity ea methapo ea carotid mme e amana hampe le cervical femoral pulse wave velocity (PWV), empa ha e bonahatsoe ho carotid artery intima-media thickness (IMT).12 Leha ho le joalo, kotsi ea pelo pakeng tsa lilemo tsa 12-18 e amahanngoa le keketseho ea carotid IMT bophelong ba lilemong tse bohareng, 'me ha e amane le maemo a kotsi ka nako e tšoanang.13 Bopaki bo mabapi le matla a litloaelano tsena bongoaneng ha bo eo.
Mosebetsing oa rona o fetileng, ha rea ​​​​ka ra fumana liphello tsa lefu la tsoekere la bokhachane kapa mekhoa ea bophelo ea bakhachane ho anthropometry ea bongoaneng, sebopeho sa 'mele kapa boholo ba arterial le mosebetsi.14 Sepheo sa tlhahlobo ena ke mokhoa o fapaneng oa ho kopanya kotsi ea pelo.Sehlopha le phello ea eona ho arterial phenotype ea bana.Re nahana hore ICVH ea 'mè le li-vascular substitutes bakeng sa lefu la pelo le methapo li tla bontšoa ho ICVH ea bongoaneng le li-phenotypes tsa arterial bongoaneng.
Lintlha tse fapaneng li tsoa ho latela lilemo tse tšeletseng tsa Finnish Gestational Diabetes Prevention Study (RADIEL).Moralo oa pele oa lipatlisiso o hlahisitsoe libakeng tse ling.15 Ka bokhutšoanyane, basali ba rerang ho ima kapa ba halofong ea pele ea bokhachane mme ba na le kotsi e eketsehileng ea lefu la tsoekere nakong ea bokhachane (botenya le / kapa histori ea lefu la tsoekere la gestational) ba hiriloe (N=728).Telo-morao ea lilemo tse 6 ea methapo ea pelo e entsoe e le phuputso ea tlhokomeliso ea lipara tsa bo-mme le masea, ka palo e lekanang ea bo-'m'e ba nang le lefu la tsoekere nakong ea bokhachane le ba se nang bona, ba nang le sehlopha se boletsoeng esale pele (~200).Ho tloha ka Phuptjane 2015 ho fihlela ka Mots'eanong 2017, limemo tse tsoelang pele li rometsoe ho barupeluoa ho fihlela moeli o fihletsoe, 'me lipara tse 201 tsa li-tuples tse peli li ile tsa ngolisoa.Tsoelo-pele e etselitsoe bana ba lilemo tse 5-6 ho netefatsa tšebelisano ntle le sedation, ho kenyeletsoa tlhahlobo ea sehlopha sa bo-'m'a-lesea sa sehlopha sa 'mele le sebopeho, khatello ea mali, tsoekere e potlakileng ea mali le lipids tsa mali, boikoetliso ba' mele bo sebelisang li-accelerometers, boleng ba lijo le lipids tsa mali. lipotso tsa ho tsuba (bo-'mè), methapo ea mali Ultrasound le intraocular pressure measurement le echocardiography ho bana.Boteng ba data bo thathamisitsoe ho Supplementary Table S1.Komiti ea Melao ea Boitšoaro ea Bongaka le Botho, Lingaka tsa Bana le Psychiatry ea Sepetlele sa Univesithi ea Helsinki e amohetse protocol ea lipatlisiso (20/13/03/03/2015) bakeng sa tlhahlobo ea morao-rao ea lilemo tse tšeletseng.Tumello e ngotsweng e tsebiswang ke bomme bohle e ile ya fumanwa ka nako ya ngodiso.Thuto e ile ea etsoa ho latela Phatlalatso ea Helsinki.
Mofuputsi ea nang le tsebo (TS) o sebelisa li-transducers tsa 25 MHz le 35 MHz tse nang le tsamaiso ea Vevo 770, 'me o sebelisa UHF22, UHF48 (setsi se tšoanang sa frequency) le Vevo MD system (VisualSonics, Toronto, Canada) e le lipara tsa ho qetela tse 52 tsa 'mè le ngoana.Mothapo o tloaelehileng oa carotid o ne o tšoantšoe 1 cm e haufi le li-bulbs tsa carotid tsa linaha tse peli, 'me boemo ba ho phomola bo ne bo le boemong ba supine.Sebelisa maqhubu a phahameng ka ho fetisisa a ka bonang lebota le hole ho fumana litšoantšo tsa boleng bo holimo tse koahelang lipotoloho tse 3-4 tsa pelo.Sebelisa Vevo 3.0.0 (Vevo 770) e nang le li-caliper tsa elektroniki tsa matsoho le software ea VevoLab (Vevo MD) ho sekaseka litšoantšo ntle le marang-rang.16 Lumen bophara le IMT li ne li lekantsoe ke motho ea nang le phihlelo ea ho shebella (JKMS) qetellong ea diastole a sebelisa mekhoa ea ho itšeha), e sa tsebeng litšobotsi tsa sehlooho (Supplementary Figure S1).Re tlalehile pejana hore coefficient ea intra-observer ea phapang e lekantsoeng ka ultra-high-resolution ultrasound ho bana le batho ba baholo ke 1.2-3.7% ka bophara ba lumen, IMT ke 6.9-9.8%, 'me coefficient ea inter-observer ea phapang ke 1.5-4.6% ka bophara ba lumen., 6.0-10.4% ea IMT.Lintlha tsa carotid IMT Z tse fetotsoeng bakeng sa lilemo le bong li ile tsa baloa ho sebelisoa litšupiso tsa bana ba basoeu ba sa nonaneng ba phetseng hantle.17
Bophahamo ba lumen ea methapo ea carotid bo ile ba lekanyetsoa tlhōrōng ea systole le end-diastole ho hlahloba mothapo oa carotid β stiffness index le coefficient ea ho atolosa methapo ea carotid.Ho sebelisoa cuff e boholo bo loketseng, mokhoa oa oscillometric (Dinamap ProCare 200, GE) o ile oa sebelisoa ho rekota khatello ea mali ea systolic le diastolic bakeng sa lipalo tsa ts'ebetso ea elastic nakong ea ho nka litšoantšo tsa ultrasound sebakeng sa supine sa letsoho le letona.Coefficient ea katoloso ea mothapo oa carotid le index ea β-stiffness ea methapo ea carotid e baloa ho tsoa mothapong oa carotid ho sebelisoa foromo e latelang:
Har'a bona, CCALAS le CCALAD ke sebaka se tloaelehileng sa lumen ea methapo ea carotid nakong ea systole le diastole ka ho latellana;CCALDS le CCALDD ke methapo e tloaelehileng ea carotid lumen bophara nakong ea systole le diastole ka ho latellana;SBP le DBP ke khatello ea mali ea systolic le diastolic.18 Coefficient ea phapang ea coefficient ea katoloso ea methapo ea carotid ho motho ea shebelletseng ke 5.4%, tekanyo ea ho fapana ha methapo ea carotid β stiffness index ke 5.9%, le "inter-observer coefficient" ea ho atolosoa ha methapo ea carotid ke 11.9% coefficient le 12.8% ea mothapo oa carotid β stiffness index .
Ho ile ha sebelisoa mochine oa khale oa "high-resolution ultrasound Vivid 7 (GE) o nang le transducer ea mela ea 12 MHz ho tsoela pele ho lekola mothapo oa carotid bakeng sa letlapa.Ho qala ho tloha mothapong o tloaelehileng oa carotid haufi le tleloubu, mothapo oa carotid o hlahlojoa ka mahlakore ka bobeli ka ho bifurcation le karolo ea proximal ea methapo ea ka hare le e ka ntle ea carotid.Ho ea ka tumellano ea Mannheim, letlapa le hlalosoa e le 1. Ho teteka ha sebaka sa lebota la sekepe ka 0.5 mm kapa 50% ea IMT e potolohileng kapa 2. Kakaretso ea botenya ba marako a arterial e feta 1.5 mm.19 Boteng ba plaque bo ile ba hlahlojoa ka ho fapana.Mohlokomeli ea ka sehloohong (JKMS) ka boithaopo o etsa litekanyo tse pheta-phetoang karolong e nyenyane ea litšoantšo (N = 40) ho hlahloba phapang ea intra-observer, 'me molebeli oa bobeli (TS) o hlahloba ho fapana ha li-inter-observer.Cohen κ ea ho fetoha ha intra-observer le ho fapana ha li-inter-observer e ne e le 0.89 le 0.83, ka ho latellana.
PWV e ile ea lekanyetsoa ke mooki ea koetlisitsoeng oa lipatlisiso ho lekola ho satalla ha methapo ea tikoloho a sebelisa sensor ea mochini (Complior Analyse, Alam Medical, Saint-Quentin-Fallavier, Fora) ha a ntse a phomotse sebakeng sa supine.20 Li-sensor li behiloe mothapong o nepahetseng oa carotid, mothapo oa radial o ka ho le letona, le mothapo o nepahetseng oa setho sa botšehali ho lekola bohareng (mothapo o nepahetseng oa carotid-femoral artery) le peripheral (right carotid artery-radial artery) nako ea transit.Sebelisa tepi ho lekanya sebaka se tobileng pakeng tsa lintlha tsa ho rekota ho ea haufi le 0.1 cm.Bohole bo nepahetseng ba mothapo oa mali oa carotid oa femoral bo atisoa ka 0.8 ebe bo sebelisoa lipakeng tsa lipalo tsa PWV.Pheta rekoto sebakeng sa supine.Lirekoto tse peli li ile tsa fumanoa ha tlaleho ea boraro e etsoa sebakeng seo phapang pakeng tsa litekanyo e neng e le kholo ho feta 0.5 m/s (10%).Sebakeng sa litekanyo tse fetang tse peli, sephetho se nang le boleng bo tlase ba mamello se sebelisoa bakeng sa tlhahlobo.Mamello ke parameter ea boleng e lekanyang ho fetoha ha leqhubu la pulse nakong ea ho rekota.Sebelisa karolelano ea bonyane litekanyo tse peli tlhahlobong ea ho qetela.PWV ea bana ba 168 e ka lekanngoa.Coefficient ea phapang ea litekanyo tse pheta-phetoang e ne e le 3.5% bakeng sa methapo ea carotid-femoral PWV le 4.8% bakeng sa methapo ea carotid-radial PWV (N = 55).
Sete ea li-binary indicators tse tharo li sebelisoa ho bonahatsa subclinical atherosclerosis ea 'm'e: ho ba teng ha carotid artery plaque, carotid artery IMT e fetotsoeng lilemo le ho feta 90th percentile sampuling ea rona, le ho feta karolo ea 90 lekholong The PWV ea molala le femur e bapisoa. ka lilemo le khatello e phahameng ea mali.mashome a mabeli a motso o le mong
ICVH ke sete sa 7 binary indicators with a cumulative range from 0 to 7 (e phahameng ea lintlha, e tsamaellana le litataiso).4 Lipontšo tsa ICVH tse sebelisitsoeng thutong ena li lumellana le tlhaloso ea pele (liphetoho tse tharo li entsoe) -Supplementary Table S2) 'me e kenyelletsa:
Boleng ba lijo bo hlahlojoa ke Finnish Child Healthy Eating Index ea ngoana (range 1-42) le index ea 'm'e ea bophelo bo botle ba ho ja lijo (range 0-17).Li-index ka bobeli li akaretsa 4 ea mekhahlelo e 5 e kenyellelitsoeng ho sesupo sa lijo tsa mantlha (ntle le ho noa sodium).23,24 Bohlokoa ba bohlokoa ba boleng ba lijo bo nepahetseng le bo sa lokelang bo hlalosoa e le 60% kapa ho feta ho bonahatsa boleng ba lijo tsa pele.Tlhaloso ea sesupo (e loketse haeba ho feta 3 ea litekanyetso tse 5).Mabapi le palo ea morao-rao e phetseng hantle ea bana ba Finnish (87.7% bakeng sa banana, 78.2% bakeng sa bashanyana), haeba moeli o ikhethileng oa tekano bakeng sa bana ba batenya o feta, BMI ea ngoana e hlalosoa e sa nepahala, e fapaneng hanyane le 85. % ea baahi ba Finland.22 Ka lebaka la palo e kholo ea ba tlohelang sekolo le boleng bo tlaase haholo ba khethollo (Tlhaloso ea Tlatsetso S1, 96% ea bo-'mè ba finyella litekanyetso tsa ICVH), ho ikoetlisa ha basali ba baimana le ba robetseng ho ne ho sa kenyelletsoa.ICVH e arotsoe ka lihlopha tse latelang: tlaase (bana 0-3, bo-'mè 0-2), ba mahareng (bana ba 4, bo-'mè ba 3-4) le ba phahameng (bana le bo-'mè ba 5-6), ho fana ka monyetla oa ho bapisa lihlopha tse fapaneng. .
Sebelisa lisebelisoa tsa elektronike (Seca GmbH & Co. KG, Germany) ho lekanya bolelele le boima ba 'mele ho 0.1 cm e haufi le 0.1 kg.Liphetho tsa bana tsa BMI Z li hlahisoa ho ipapisitsoe le sete ea data ea morao-rao ea batho ba Finnish.22 Sebopeho sa 'mele se fetisitse tlhahlobo ea "bioelectrical impedance" (InBody 720, InBody Bldg, Korea Boroa).
Khatello ea mali e phomotseng e ne e lekantsoe ka mokhoa oa oscillometric ho tloha letsohong le letona sebakeng se lutseng (Omron M6W, Omron Healthcare Europe BV, The Netherlands) e nang le cuff e lekaneng.Karolelano ea khatello ea mali ea systolic le diastolic e baloa ho tloha litekanyong tse peli tse tlase (bonyane ba litekanyo tse tharo).Khatello ea mali ea bana ea Z e baloa ho latela litataiso.25
Lisampole tsa mali tsa tsoekere ea plasma le lipids li ile tsa bokelloa tlas'a maemo a ho itima lijo.Liphetho tse tsoang ho bana ba 3 ba nang le ho itima lijo ka mokhoa o sa tsitsang (li-triglycerides tse ngata haholo, tsoekere e potlakileng ea mali, le glycosylated hemoglobin A1c (HbA1c)) ha lia kenyelletsoa tlhahlobong.Kakaretso ea k'holeseterole, k'holeseterole ea low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol le triglycerides li khethoa ka mokhoa oa enzymatic, plasma glucose le enzymatic hexokinase determination, le HbA1c le immunoturbidimetric analyzer (Roche Diagnostics, Basel, Switzerland) bakeng sa ho hlahlojoa .
Ho ja lijo tsa 'm'a ho ile ha lekoa ka lethathamo la lipotso tsa khafetsa tsa lijo 'me tsa hlahlojoa hape ke index ea lijo tse phetseng hantle.The Healthy Food Intake Index e kile ea tiisoa e le sesebelisoa se molemo sa ho bonahatsa ho lumellana le Nordic Nutrition Recommendation 26 sehlopheng sa pele sa RADIEL.24 Ka bokhutšoane, e na le metsoako e 11, e koahelang tšebeliso ea meroho, litholoana le monokotšoai, lijo-thollo tse nang le fiber e ngata, tlhapi, lebese, chisi, oli e phehang, lisoso tse mafura, lijo tse bobebe, lino tse tsoekere le lijo tse potlakileng.Ho phahama ha lintlha ho bontša hore ho na le tekanyo e phahameng ea ho lumellana le likhothaletso.Boleng ba lijo tsa bana bo ile ba hlahlojoa ka litlaleho tsa lijo tsa matsatsi a 3 'me tsa hlahlojoa ka ho eketsehileng ke Finnish Children's Healthy Eating Index.Lenane la ho ja lijo tse phetseng hantle tsa bana ba Finnish le kile la netefatsoa ho baahi ba bana ba Finland.23 E akarelletsa mefuta e mehlano ea lijo: meroho, litholoana le monokotšoai;oli le margarine;lijo tse nang le tsoekere e ngata;litlhapi le litlhapi le meroho;le lebese la skimmed.Tšebeliso ea lijo e fuoa lintlha e le hore ha tšebeliso e phahameng, e be le lintlha tse phahameng.Ntle le lijo tse nang le tsoekere e ngata, lintlha li khutlisetsoa morao.Pele o kenya lintlha, fetola matla a matla ka ho arola ho noa (ligrama) ka matla a matla (kcal).Ha lintlha li phahame, lijo tsa bana li ntlafala.
Boikoetliso ba 'mele bo itekanetseng ho isa ho bo matla (MVPA) bo ile ba lekanyetsoa ho sebelisoa hip accelerometer ea ngoana (ActiGraph GT3X, ActiGraph, Pensacola, USA) le lebanta la 'mè la letsoho (SenseWear ArmBand Pro 3).E laetsoe ho roala mochine nakong ea ho falimeha le ho robala, empa nako ea ho robala e ne e sa kenyelletsoa tlhahlobo.Mohlokomeli oa bana o bokella lintlha ka tekanyo ea sampole ea 30 Hz.Lintlha hangata lia hloekisoa, li fetoleloa ho palo ea nako ea metsotsoana e 10, 'me li hlahlojoe ho sebelisoa Evenson (2008) cut point (≥2296 cpm).27 Mohlokomeli oa 'm'e o bokella boleng ba MET nakong ea metsotsoana e 60.MVPA e baloa ha boleng ba MET bo feta 3. Tekanyo e sebetsang e hlalosoa e le bonyane matsatsi a sebetsang a 2 le mafelo-beke a 1 (ho rekota bonyane metsotso ea 480 ka letsatsi) le matsatsi a 3 a ho sebetsa le mafelo-beke a 1 (ho rekota bonyane metsotso ea 720 ka letsatsi) bakeng sa mme.Nako ea MVPA e baloa e le karolelano e boima [(karolelano ea metsotso ea MVPA / letsatsi matsatsing a beke × 5 + karolelano ea metsotso ea MVPA / letsatsi ka mafelo-beke × 2) / 7], ho phaella moo, e le peresente ea nako eohle ea ho apara.Lintlha tsa morao-rao tsa ts'ebetso ea 'mele tsa batho ba Finland li sebelisitsoe e le litšupiso.28
Lenane la lipotso le ile la sebelisoa ho fumana boitsebiso bo mabapi le ho tsuba ha ’mè, mafu a sa foleng, meriana le thuto.
Lintlha li hlahisoa e le tse bolelang ± SD, median (interquartile range) kapa lipalo (peresente).Lekola kabo e tloaelehileng ea mefuta eohle e tsoelang pele e thehiloeng ho histogram le morero o tloaelehileng oa QQ.
Tlhahlobo e ikemetseng ea tlhahlobo ea t, tlhahlobo ea Mann-Whitney U, tlhahlobo ea tsela e le 'ngoe ea phapang, Kruskal-Wallis, le teko ea chi-square li ile tsa sebelisoa e le tse loketseng lihlopha tsa papiso ('mè le ngoana, moshanyana le ngoanana, kapa ICVH e tlaase le e bohareng le e phahameng. ).
Pearson kapa Spearman boemo ba corelation coefficient e ne e sebelisetsoa ho hlahloba kamano e sa tšoaneng pakeng tsa litšobotsi tsa ngoana le 'mè.
Ho ile ha sebelisoa mohlala oa multivariate linear regression ho theha mohlala o hlalosang k'holeseterole ea HDL ea bana le carotid IMT.Khetho e fapaneng e ipapisitse le khokahano le kahlolo ea kliniki ea litsebi, e qoba mefuta e mengata ea bohlokoa ea mohlala, 'me e kenyelletsa lintlha tse ka ferekanyang.Multicollinearity e hlahlojoa ho sebelisoa phapang ea theko ea lichelete, e nang le boleng bo phahameng ba 1.9.Multivariate linear regression e ile ea sebelisoa ho sekaseka tšebelisano.
P ≤ 0.05 e nang le mehatla e 'meli e ne e behiloe hore e be ea bohlokoa, ntle le tlhahlobo ea correlation ea li-determinants tsa methapo ea carotid IMT ho bana ba nang le P ≤ 0.01.
Litšobotsi tsa barupeluoa li bontšoa ho Lethathamo la 1 le Letlapa la Tlatsetso la S3.Ha ho bapisoa le palo ea litšupiso, lintlha tsa bana tsa BMI Z le BP Z li eketsehile.Mosebetsi oa rona o fetileng o tlalehile lintlha tse qaqileng mabapi le arterial morphology ho bana.14 Ke bana ba 15 (12%) feela le bo-'mè ba 5 (2.7%) ba ileng ba finyella litekanyetso tsohle tsa ICVH (Litšoantšo tsa Tlatsetso 2 le 3, Litafole tsa Tlatsetso S4-S6).
Lintlha tse akaretsang tsa 'm'a le masea tsa ICVH li amana feela le bashanyana (bashanyana: rs=0.32, P=0.01; banana: rs=-0.18, P=0.2).Ha e hlahlojoa e le phetoho e tsoelang pele, tlhahlobo ea kamano e sa tšoaneng ea 'm'a le lesea e na le bohlokoa ba bohlokoa ho lekanya lipids ea mali, HbA1C, botenya, khatello ea mali ea diastolic, le boleng ba lijo (Supplementary Figures S4-S10).
LDL, HDL ea bana le bo-’mè, le kakaretso ea k’holeseterole li amana (r=0.23, P=0.003; r=0.35, P<0.0001; r=0.24, P=0.003, Figure 1).Ha e hlophisoa ho ea ka bong ba ngoana, kamano pakeng tsa LDL ea ngoana le 'm'a le k'holeseterole eohle e ile ea lula e le ea bohlokoa ho bashanyana feela (Tlaleho ea Tlatsetso S7).Triglycerides le HDL k'holeseterole li amahanngoa le peresente ea mafura a 'mele oa banana (rs = 0.34, P = 0.004; r = -0.37, P = 0.002, ka ho latellana, Figure 1, Supplementary Table S8).
Setšoantšo sa 1 Kamano lipakeng tsa lipids tsa mali a ngoana le 'm'a.Morero oa ho hasanya o nang le mohala oa ho theola maemo (95% nako ea boitšepo);(AC) maemo a mali a bo-'mè le a lesea;(D) peresente ea mafura a 'mele oa ngoanana le k'holeseterole e phahameng ea density lipoprotein.Liphetho tsa bohlokoa li bontšoa ka mongolo o motenya (P ≤ 0.05).
Likhuts'oane: LDL, low-density lipoprotein;HDL, high-density lipoprotein;r, Pearson coefficient ea khokahano.
Re fumane hore ho na le kamano e kholo pakeng tsa HbA1C ea ngoana le 'm'a (r=0.27, P=0.004), empa e ne e sa amane le ho itima lijo maling a tsoekere (P=0.4).Lipalo tsa bana tsa BMI Z, empa eseng liperesente tsa mafura a 'mele, li amana hantle le BMI ea 'm'e le karo-karolelano ea thekeng-to-hip (r=0.17, P=0.02; r=0.18, P=0.02, ka ho latellana).Boleng ba Z ba khatello ea mali ea diastolic ea bana bo amana ka mokhoa o fokolang le khatello ea mali ea 'm'e ea diastolic (r=0.15, P=0.03).Lenane la lijo tse phetseng hantle tsa bana ba Finland le amana le index ea phepo e nepahetseng ea 'm'e (r=0.22, P 0.002).Kamano ena e ne e bonoa feela ho bashanyana (r=0.31, P=0.001).
Ka mor’a ho qhelela ka thōko bo-’mè ba neng ba phekoloa khatello ea mali, hypercholesterolemia, kapa hyperglycemia, liphello li ne li tšoana.
Tlhaloso e qaqileng ea arterial phenotype e bontšoa ho Supplementary Table S9.Sebopeho sa methapo ea bana se ikemetse ka litšobotsi tsa bana (Supplementary Table S10).Ha rea ​​ka ra boloka kamano leha e le efe pakeng tsa bongoana ba ICVH le sebopeho sa vascular kapa mosebetsi.Ha re hlahloba bana ba qhetsoeng ke lintlha tsa ICVH, re hlokometse hore palo ea bana ba carotid IMT Z ba nang le lintlha tse itekanetseng feela e eketsehile ha e bapisoa le bana ba nang le lintlha tse tlaase (bolela ± SD; lintlha tse itekanetseng 0.41 ± 0.63 vs low score- 0.07 ± 0.71, P = 0.03, Letlapa la Tlatsetso S11).
ICVH ea 'mè ha e amane le vascular phenotype ea bana (Supplementary Tables S10 le S12).Bana le methapo ea kutlo ea 'm'a IMT e amana (Setšoantšo sa 2), empa kamano ea 'm'a le ngoana pakeng tsa litekanyetso tse fapaneng tsa ho satalla ha methapo ha e bohlokoa ho ea ka lipalo (Letlapa la Tlatsetso 9, Setšoantšo sa Tlatsetso S11).Moetsong oa ho toloka ka mokhoa o fapaneng o lokiselitsoeng bakeng sa bong ba bana, lilemo, khatello ea mali ea systolic, boima ba 'mele bo fokolang, le peresente ea mafura a' mele, carotid IMT ke eona feela selelekela se ikemetseng sa carotid IMT ea bana (e fetotsoeng R2 = 0.08).Bakeng sa keketseho e 'ngoe le e 'ngoe ea 1 mm ho IMT ea carotid ea 'm'a, carotid IMT ea bongoaneng e eketsehile ka 0.1 mm (95% CI 0.05, 0.21, P = 0.001) (Tlaleho ea Tlatsetso S13).Bong ba ngoana ha boa ka ba fokotsa phello ena.
Setšoantšo sa 2 Kamano lipakeng tsa botenya ba methapo ea methapo ea carotid ho bana le bo-mme.Morero oa ho hasanya o nang le mohala oa ho theola maemo (95% nako ea boitšepo);(A) carotid ea 'mè le ngoana IMT, (B) carotid ea 'm'a IMT percentile le ngoana carotid IMT z-score.Liphetho tsa bohlokoa li bontšoa ka mongolo o motenya (P ≤ 0.05).
Palo ea methapo ea mali ea 'm'a e amahanngoa le coefficient ea katoloso ea methapo ea carotid le β stiffness index ho bana (rs=-0.21, P=0.007, rs=0.16, P=0.04, Supplementary Table S10, ka ho latellana).Bana ba tsoetsoeng ke bo-'m'a ba nang le lintlha tsa vascular tsa 1-3 ba na le coefficient e tlase ea ho atolosoa ha methapo ea carotid ho feta ba tsoetsoeng ke bo-'mè ba nang le lintlha tse 0 (ho bolela ho kheloha ho tloaelehileng, 1.1 ± 0.2 vs 1.2 ± 0.2%/10 mmHg, P= 0.01) 'me ho na le tšekamelo ea ho eketsa sekhahla sa carotid β stiffness index (median (IQR), 3.0 (0.7) le 2.8 (0.7), P = 0.052) le methapo ea carotid IMT (e bolela ± SD, 0.37 ± 0.04 ± 0.35 le 0.3 ± 0.3 mm, P=0.06) (Setšoantšo sa 3), Letlapa la Tlatsetso S14).
Setšoantšo sa 3 Child vascular phenotype stratified by maternal vascular score.Lintlha li hlahisoa e le tse bolelang + SD, P ka tlhahlobo e ikemetseng ea sampole t (A le C) le tlhahlobo ea Mann-Whitney U (B).Liphetho tsa bohlokoa li bontšoa ka mongolo o motenya (P ≤ 0.05).Palo ea methapo ea mali ea 'm'a: sebaka sa 0-3, sete ea matšoao a mararo a binary: boteng ba letlapa la carotid, botenya ba methapo ea methapo ea carotid intima-media bo fetotsoeng ke lilemo mme bo feta 90% sampoleng ea rona, le leqhubu la pulse la cervical-femoral. lebelo le fetang 90% li tsamaellana le lilemo le khatello e phahameng ea mali.mashome a mabeli a motso o le mong
Palo ea bakhachane (ICVH, vascular score) le motsoako oa lintlha tsa bana le bakhachane ha li amane le arterial phenotype ea bana (Supplementary Table S10).
Tlhahlobisisong ena ea bo-'m'e le bana ba bona ba lilemo tse 6, re ile ra batlisisa kamano pakeng tsa ICVH ea bongoaneng, ICVH ea 'm'a, le "maternal subclinical atherosclerosis" le sebopeho le tšebetso ea methapo ea bana.Ntho e ka sehloohong e sibolotsoeng ke hore feela subclinical atherosclerosis ea 'mè, ha maemo a tloaelehileng a kotsi a pelo ea bana le' mè ha a amane le liphetoho tse mpe nakong ea bongoaneng ba vascular phenotypes.Kutloisiso ena e ncha mabapi le nts'etsopele ea methapo ea bongoana ea bongoaneng e eketsa kutloisiso ea rona ea phello ea meloko e fapaneng ea subclinical atherosclerosis.
Re tlaleha bopaki ba ho fokotseha ha methapo ea carotid le mekhoa ea ho satalla ha methapo ea carotid le methapo ea carotid IMT ho bana ba bo-'mè ba nang le li-cardiovascular disease vascular substitutes.Leha ho le joalo, ha ho na kamano e tobileng pakeng tsa matšoao a ts'ebetso ea methapo ea 'mè le lesea.Re nahana hore ho kenyelletsa letlapa la bakhachane ka har'a palo ea methapo ea mali ho eketsa boleng ba eona ba ho bolela esale pele.
Re hlokometse kamano e ntle pakeng tsa methapo ea carotid IMT ho bana le bo-'mè;leha ho le joalo, mochine o ntse o sa hlaka hobane methapo ea carotid IMT ho bana e ikemetse ka litšobotsi tsa ngoana le 'mè.Kamano lipakeng tsa lintlha tsa bana tsa ICVH le carotid IMT e bonts'itse ho se lumellane, hobane ha rea ​​bona phapang ea letho lipakeng tsa ICVH e tlase le ICVH e phahameng.
Rea tseba hore lintlha tse ling li ka phetha karolo, ho kenyelletsa le selikalikoe sa hlooho ea bana, e ka 'nang ea e-ba sesupo sa bohlokoa sa boholo ba methapo ea carotid nakong ea pele ea kholo.Ho phaella moo, liphello tsa rona li ka 'na tsa bakoa ke lintlha tse sa lekanyetsoang tse amang tsoelo-pele ea methapo ea lesea.Leha ho le joalo, re kile ra tlaleha hore pele ho boimana ho feta boima ba 'mele / botenya le lefu la tsoekere nakong ea bokhachane ha li na phello ho ngoana oa pele oa carotid IMT.14 Lipatlisiso tse ling lia hlokahala ho hlahloba tšusumetso ea sebōpeho sa methapo le tšebetso ea khōlo ea bana le semelo sa lefutso.
Mekhatlo e tlalehiloeng e lumellana le liphuputso tse fetileng tse entsoeng ho bacha, tse faneng ka bopaki ba likamano pakeng tsa motsoali le ngoana vascular phenotypes, ho akarelletsa le carotid IMT, le hoja boholo ba 'mele bo sa ka ba fetoloa tlhahlobisong.29 Lefa le leholo la carotid IMT le tiisa taba ena le ho satalla ha methapo ea batho ba baholo.30,31
Kamano e hlokometsoeng pakeng tsa lefu la atherosclerosis ea bo-'mè le vascular phenotype ea bongoaneng ha ea ka ea atolosoa ke ICVH ea 'mè.Sena se lumellana le lithuto tse fetileng tseo ho tsona karolo e kholo ea phapang ea phanotype ea methapo ea bana e hlalosoang ke liphatsa tsa lefutso tse ikemetseng ntle le maemo a tloaelehileng a kotsi a pelo ea batsoali le bana.29
Ho phaella moo, liphetoho tsa methapo ea methapo ha li amane le ICVH ea bongoaneng, e bontšang tšusumetso e kholo ea liphatsa tsa lefutso tsa bongoaneng.Tlatsetso ea maemo a tikoloho e bonahala e fetoha le lilemo tsa bana, kaha phuputso e fetileng e kholo ea lihlopha tsa bana ba lilemo li 11-12 e tlalehile kamano e kholo pakeng tsa mosebetsi oa methapo ea bana le ICVH.12