Cullen P, Funke H
Institute of Arteriosclerosis Research, Muenster, Germany.
Nutr Metab Cardiovasc Dis. 2001 Oct;11 Suppl 5:45-51.
Most male citizens of Western countries already have some degree of atherosclerosis by the age of 18, indicating that initiation of atherosclerosis in childhood is a virtually ubiquitous process. This process has a strong genetic component. However, identifying the exact nature of that component is not an easy task, because in the overwhelming majority of cases atherosclerosis is due not to disorders in single genes but to the effects of many genes operating together against a variable environmental background. The preliminary results of the sequencing of the human genome indicate fewer genes, but more complexity in the regulation of the expression of these genes, than was previously thought. For these reasons it is likely that prediction and management of atherosclerotic risk in children in the next years will depend not on the results of genetic testing, but on the differentiated analysis of classical risk factors. These issues are discussed in detail in this review.
西方国家的大多数男性公民在18岁时就已经有一定程度的动脉粥样硬化，这表明儿童期动脉粥样硬化的起始实际上是一个普遍存在的过程。这个过程有很强的遗传成分。然而，确定该成分的确切性质并非易事，因为在绝大多数情况下，动脉粥样硬化并非由单个基因紊乱所致，而是许多基因在可变的环境背景下共同作用的结果。人类基因组测序的初步结果表明，基因数量比之前认为的要少，但这些基因表达调控的复杂性更高。由于这些原因，未来几年儿童动脉粥样硬化风险的预测和管理可能不取决于基因检测结果，而是取决于对经典风险因素的差异化分析。本综述将详细讨论这些问题。
