Benjamin Emelia J, Larson Martin G, Keyes Michelle J, Mitchell Gary F, Vasan Ramachandran S, Keaney John F, Lehman Birgitta T, Fan Shuxia, Osypiuk Ewa, Vita Joseph A
Evans Department of Medicine, Boston University School of Medicine, Framingham Study, Boston, Mass 01702-5827, USA.
Circulation. 2004 Feb 10;109(5):613-9. doi: 10.1161/01.CIR.0000112565.60887.1E.
Studies in selected samples have linked impaired endothelial function with cardiovascular disease and its risk factors. The clinical correlates and heritability of endothelial function in the community have not been described.
We examined a measure of endothelial function, brachial artery flow-mediated dilation (FMD), expressed as both percent (FMD%) and actual dilation by ultrasound with the occlusion cuff below the elbow in 2883 Framingham Study participants (52.9% women; mean age, 61 years). A subset of 1096 participants performed a 6-minute walk test before FMD determination. Mean FMD% was 3.3+/-3.0% in women and 2.4+/-2.4% in men. In stepwise multivariable linear regression models, FMD% was inversely related to age, systolic blood pressure, body mass index (BMI), lipid-lowering medication, and smoking, whereas it was positively related to female gender, heart rate, and prior walk test. The estimated heritability of FMD% was 0.14. FMD actual dilation findings were similar, except that female sex and BMI were not significantly associated.
Increasing age, systolic blood pressure, BMI, and smoking were associated with lower FMD% in our community-based sample, whereas prior exercise and increasing heart rate were associated with higher FMD%. The estimated heritability of FMD was modest. Future research will permit more complete characterization of the genetic and environmental determinants of endothelial function and its prognostic value in the community.
对特定样本的研究已将内皮功能受损与心血管疾病及其危险因素联系起来。社区中内皮功能的临床相关性和遗传性尚未得到描述。
我们在2883名弗雷明汉心脏研究参与者（52.9%为女性；平均年龄61岁）中，通过在肘部下方使用袖带阻断，用超声检测了一种内皮功能指标——肱动脉血流介导的舒张功能（FMD），以百分比（FMD%）和实际舒张值表示。1096名参与者的一个子集在进行FMD测定前进行了6分钟步行试验。女性的平均FMD%为3.3±3.0%，男性为2.4±2.4%。在逐步多变量线性回归模型中，FMD%与年龄、收缩压、体重指数（BMI）、降脂药物使用和吸烟呈负相关，而与女性性别、心率和之前的步行试验呈正相关。FMD%的估计遗传度为0.14。FMD实际舒张值的结果相似，只是女性性别和BMI无显著关联。
在我们基于社区的样本中，年龄增加、收缩压升高、BMI增加和吸烟与较低的FMD%相关，而之前的运动和心率增加与较高的FMD%相关。FMD的估计遗传度适中。未来的研究将更全面地描述社区中内皮功能的遗传和环境决定因素及其预后价值。
