基于靶器官损害结局构建心血管疾病儿童期预警指标体系

Cardiovascular disease (CVD) is a severe public health issue in China. During recent years, obesity, elevated blood pressure, abnormal lipid and glucose metabolisms, and unhealthy lifestyles become epidemic in Chinese children and adolescents, which increase risk of childhood target organ damage and adulthood CVD. Thus, it is urgent to establish childhood early warning indicators of CVD, in order to curb the epidemiology of CVD. Our study is based on the baseline data from the National Science-technology Support Plan Project named “Cardiovascular disease early warning, diagnosis and treatment technology research in childhood” in June, 2014. A total of 1800 children aged 9-14 years old were included and all participants have completed physical examination, blood pressure measurements, blood lipid and glucose, and a validated questionnaire (including lifestyle and nutrition information). We plan to follow up them during the period of June, 2017 to June, 2018, and to assess their target organ damage including heart, blood vessel, kidney and liver. Based on target organ damage in childhood, the aim of our study is to establish childhood warning indicators of CVD that accord with the growth and development characteristics of Chinese children. In addition, our study is to develop the simple assessment tool that could be used in school health and child health care in clinic practice, in order to prevent childhood target organ damage, thereby decreasing risk of CVD in adulthood.

心血管疾病已成为影响我国居民健康的严重公共卫生问题。近年来，我国儿童青少年肥胖、血压偏高、血脂和血糖代谢异常以及不良生活方式呈现流行趋势。这增加了儿童期靶器官损害以及成年期心血管疾病的风险，因此，迫切需要构建心血管疾病儿童期预警指标体系，从源头上遏制我国心血管疾病的流行。本研究拟以国家科技支撑项目“儿童心血管疾病的预警、诊治技术研究”济南调查点基线数据为基础（2014年6月建立），选取1800余名9-14岁的中小学生，已完成身体和血压测量、血脂和血糖检测、问卷调查（包括生活行为和营养膳食信息），计划于2017年6月－2018年6月对研究对象进行随访，并评估心脏、血管、肾脏和肝脏等靶器官损害。基于靶器官损害评估，本研究拟构建出符合我国儿童生长发育特点的心血管疾病儿童期预警指标体系，并开发出简易评估工具应用于学校卫生和儿童保健，从源头上预防儿童期靶器官损害，从而降低成年期心血管疾病风险。

心血管疾病已成为影响我国居民健康的严重公共卫生问题。近年来，我国儿童青少年肥胖、血压偏高、血脂和血糖代谢异常以及不良生活方式呈现流行趋势。这增加了儿童期靶器官损害以及成年期心血管疾病的风险，因此，迫切需要构建心血管疾病儿童期预警指标体系，从源头上遏制我国心血管疾病的流行。本研究基于山东省淄博市“桓台儿童心血管随访队列”，选取1515名6-11岁的儿童，进行身体和血压测量、血脂和血糖检测、问卷调查（包括生活行为和营养膳食信息），2019年12月对研究对象进行随访，并评估心脏、血管等心血管靶器官损害。基于靶器官损害的评估结局，本研究构建出符合我国儿童生长发育特点的心血管疾病儿童期预警指标体系（包括肥胖、血压偏高、血糖偏高、TG偏高、HDL-C偏低），并开发出简易评估工具（比如提出WHtR代替BMI、血压固定界值代替复杂标准、开发出儿童健康评估软件APP等）应用于学校卫生和儿童保健，从源头上预防儿童期靶器官损害，有利于降低成年期心血管疾病风险。