The pathologic precursors of CV disease are now recognized to begin in childhood. In particular, changes in CV risk factors, individually and in clusters (metabolic syndrome or Syndrome X), occur during growth and maturation in childhood. Birth weight, childhood levels of risk factor variables and parental history of CV disease are associated with risk factors including Syndrome X and the attendant CV diseases in adulthood.
The specific aims of this data analysis application are 1) to apply robust statistical models to determine the longitudinal burden of CV risk factor variables, individually and in cluster, during childhood growth and development; 2) to test the predictability of childhood longitudinal measures of risk variables for developing adult risk factors and their clustering; and 3) to examine the influence of birth weight and parental history of CV disease on the longitudinal measures of risk burden in childhood and the attendant risk in adulthood, using the existing Bogalusa Heart Study database collected over a 30-year period. The Bogalusa Heart Study, a long-term biracial (black-white) epidemiologic study of cardiovascular risk factors from birth through 44 years of age, offers an unparalleled database for achieving these aims. The study cohort includes 5483 subjects who were screened since childhood at least 3 times, with 25,982 observations. A subcohort of 1557 individuals with 3712 observations with birth weight is available for association analysis related to birth weight. Serial data on anthropometry, blood pressure, lipoproteins, insulin and glucose will be used to develop a growth curve model to depict the longitudinal patterns of CV risk variables from childhood to adulthood and a random effects model to calculate total area under the curve (AUC), incremental AUC (total AUC - baseline AUC) and linear slope in blacks and whites and males and females. The findings of the proposed data analyses will extend our knowledge on the evolution of CV risk early in life, and importantly, to the development of preventive strategies.
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