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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青年期炎症的轨迹以及成年期精神和心脏代谢紊乱的风险


重要性研究表明，低度、未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结局。目的检查儿童和青少年大样本中通过 C 反应蛋白 （CRP） 水平测量的炎症轨迹，并探讨不同确定的轨迹与成年早期心理和相关心脏代谢健康结果之间的关联。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 Avon 父母和儿童纵向研究 （ALSPAC） 的数据，使用潜在类别生长分析 （LCGA） 来探索炎症的不同轨迹，逻辑回归探索与身心健康结果的关联。分析包括记录了可测量 CRP 数据和相关心理和心脏代谢健康结果的参与者。数据分析于 2023 年 5 月 1 日至 2024 年 3 月 30 日进行。LCGA 用于识别炎症的不同轨迹。主要结局和措施 24 岁时评估的结局包括精神障碍、抑郁症、焦虑障碍、轻躁狂症，以及作为胰岛素抵抗的衡量标准，稳态模型评估 （HOMA2） 评分。结果共纳入 6556 名参与者 （3303 [50.4%] 女性）。确定了三类炎症：持续低 CRP 水平（参考类别，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与较高的精神障碍风险相关 （比值比 [OR]，4.60;95% CI，1.81-11.70;P = .008），严重抑郁的风险更高 （OR，4.37;95% CI，1.64-11.63;P = .02），与持续低 CRP 的参与者相比，HOMA2 评分更高 （β = 0.05;95% CI，0.01-0.62，P = .04）。晚期高峰组与 24 岁时的任何结局无关。结论和相关性 低级别全身炎症在儿童中期达到高峰与成年早期的特定精神和心脏代谢障碍相关。这些发现表明，早期生活中的低度持续性炎症可能是精神-身体合并症的一个重要共同因素，因此可能与未来患者分层和风险分析的工作有关。