ImportanceResearch suggests that low-grade, nonresolving inflammation may predate adult mental and physical illness. However, evidence to date is largely cross-sectional or focuses on single disorder outcomes.ObjectivesTo examine trajectories of inflammation as measured by C-reactive protein (CRP) levels in a large sample of children and adolescents, and to explore associations between different identified trajectories and mental and related cardiometabolic health outcomes in early adulthood.Design, Setting, and ParticipantsIn a longitudinal cohort study using data from the large UK-based Avon Longitudinal Study of Parents and Children (ALSPAC), latent class growth analysis (LCGA) was used to explore different trajectories of inflammation, with logistic regression exploring association with mental and physical health outcomes. Participants with measurable CRP data and associated mental and cardiometabolic health outcomes recorded were included in the analysis. Data analysis was performed from May 1, 2023, to March 30, 2024.ExposuresInflammation was assessed via CRP levels at ages 9, 15, and 17 years. LCGA was used to identify different trajectories of inflammation.Main Outcomes and MeasuresOutcomes assessed at age 24 years included psychotic disorders, depressive disorders, anxiety disorders, hypomania, and, as a measure of insulin resistance, Homeostasis Model Assessment (HOMA2) score.ResultsA total of 6556 participants (3303 [50.4%] female) were included. Three classes of inflammation were identified: persistently low CRP levels (reference class, n = 6109); persistently raised CRP levels, peaking at age 9 years (early peak, n = 197); and persistently raised CRP levels, peaking at age 17 years (late peak, n = 250). Participants in the early peak group were associated with a higher risk of psychotic disorder (odds ratio [OR], 4.60; 95% CI, 1.81-11.70; P = .008), a higher risk of severe depression (OR, 4.37; 95% CI, 1.64-11.63; P = .02), and higher HOMA2 scores (β = 0.05; 95% CI, 0.01-0.62, P = .04) compared with participants with persistently low CRP. The late peak group was not associated with any outcomes at age 24 years.Conclusions and RelevanceLow-grade systemic inflammation peaking in midchildhood was associated with specific mental and cardiometabolic disorders in young adulthood. These findings suggest that low-grade persistent inflammation in early life may be an important shared common factor for mental-physical comorbidity and so could be relevant to future efforts of patient stratification and risk profiling.

中文翻译：

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青少年炎症的轨迹以及成年后精神和心脏代谢疾病的风险


重要性研究表明，低度、无法解决的炎症可能早于成人的精神和身体疾病。然而，迄今为止的证据主要是横断面的或侧重于单一疾病的结果。目的检查大量儿童和青少年样本中通过 C 反应蛋白 (CRP) 水平测量的炎症轨迹，并探索不同已确定轨迹之间的关联设计、设置和参与者在一项纵向队列研究中，使用来自英国大型雅芳父母和儿童纵向研究 (ALSPAC) 的数据，使用潜在类别增长分析 (LCGA)探索炎症的不同轨迹，通过逻辑回归探索与心理和身体健康结果的关联。具有可测量 CRP 数据以及记录的相关心理和心脏代谢健康结果的参与者均纳入分析。数据分析于2023年5月1日至2024年3月30日进行。暴露通过9岁、15岁和17岁的CRP水平评估炎症。 LCGA 用于识别不同的炎症轨迹。 主要结果和测量 24 岁时评估的结果包括精神障碍、抑郁症、焦虑症、轻躁狂，以及作为胰岛素抵抗指标的稳态模型评估 (HOMA2) 评分。 结果总计包括 6556 名参与者（3303 名 [50.4%] 女性）。确定了三类炎症：持续低 CRP 水平（参考类，n = 6109）； CRP 水平持续升高，在 9 岁时达到峰值（早期峰值，n = 197）； CRP 水平持续升高，在 17 岁时达到峰值（晚期峰值，n = 250）。 早期高峰组的参与者患精神障碍的风险较高（比值比 [OR]，4.60；95% CI，1.81-11.70；P = 0.008），患严重抑郁症的风险较高（OR，4.37；95）与持续低 CRP 的参与者相比，% CI，1.64-11.63；P = .02）和更高的 HOMA2 评分（β = 0.05；95% CI，0.01-0.62，P = .04）。晚高峰组与 24 岁时的任何结果无关。结论和相关性童年中期的低度全身性炎症高峰与成年早期的特定精神和心脏代谢疾病相关。这些发现表明，生命早期的低度持续性炎症可能是身心合并症的一个重要的共同因素，因此可能与未来患者分层和风险分析的工作相关。