Early childhood precursors of adult cardiovascular disease in the Australian Raine pregnancy cohort

    Research output: ThesisDoctoral Thesis

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    Abstract

    [Truncated abstract] Childhood obesity has doubled to tripled in recent decades. While possibly plateauing, they remain historically high. Recent declines in cardiovascular disease may reverse as this childhood cohort reaches middle-age, adding to substantial burdens of cardiovascular disease, currently the leading cause of death in most industrialised nations. The entire adiposity distribution has shifted upwards and no threshold exists for cardiovascular disease, signifying that cut-offs are arbitrary. Childhood obesity and related risk factors predict adult disease. Cardiovascular disease has been linked to inutero growth restriction. However, some suggest that the negative relationship between birth size and cardiovascular disease is spurious due to adjustment for current BMI. Early prevention of this epidemic requires understanding of early predictors of childhood risk factors and the relationships between the risk factors in a contemporary population. My aims were to investigate: 1. clustering of risk factors at the 8 year-old follow-up in the Raine Study and perinatal predictors of cardiovascular risk; 2. clustering of risk factors at 14 year follow up in the Raine Study, and relationship to more recent inflammatory risk markers, namely CRP and liver aminotransferases. 3. the effect of anthropometry on adolescent cardiovascular risk factors at age 14; 4. whether childhood adiposity trajectories exist and their relationship to perinatal predictors and cardiovascular risk; 1. clustering of risk factors at the 8 year-old follow-up in the Raine Study and perinatal predictors of cardiovascular risk; 2. clustering of risk factors at 14 year follow up in the Raine Study, and relationship to more recent inflammatory risk markers, namely CRP and liver aminotransferases. 3. the effect of anthropometry on adolescent cardiovascular risk factors at age 14; 4. whether childhood adiposity trajectories exist and their relationship to perinatal predictors and cardiovascular risk. These aims were explored in a prospective longitudinal study, the West Australian Raine Pregnancy Cohort. Women recruited at 16 to 20 weeks gestation during 1989-1991 had 2868 live births. Sociodemographic data, anthropometry and blood pressure were repeatedly measured at 1, 2, 3, 5, 8, 10, 14 years. Fasting blood glucose, insulin and lipids was performed on an 8 year-old subset (n=406). Children attending the entire 14 year follow-up underwent fasting glucose, insulin, lipids, C-reactive protein (CRP), uric acid, alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) (n=1377)...
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2009

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