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年轻成年人颈动脉僵硬度的相关因素:博加卢萨心脏研究

Correlates of carotid artery stiffness in young adults: The Bogalusa Heart Study.

作者信息

Urbina E M, Srinivasan S R, Kieltyka R L, Tang R, Bond M G, Chen W, Berenson G S

机构信息

Tulane Center for Cardiovascular Health, Tulane University Health Sciences Center, 1440 Canal Street, Suite 1829, New Orleans, LA 70112, USA.

出版信息

Atherosclerosis. 2004 Sep;176(1):157-64. doi: 10.1016/j.atherosclerosis.2004.04.023.

Abstract

Decreased arterial elasticity, an independent risk factor for cardiovascular (C-V) disease, is associated with C-V risk factors in middle-aged and older individuals. However, information is limited in this regard in young adults. This aspect was examined in a community-based sample of 516 black and white subjects aged 25-38 years (71% white, 39% male). The common carotid artery elasticity was measured from M-mode ultrasonography as Peterson's elastic modulus (Ep) and relative wall thickness-adjusted Young's elastic modulus (YEM). Blacks and males had higher Ep (P < 0.05); males had higher YEM (P < 0.0001); and blacks had higher wall thickness (P < 0.01). For the entire sample adjusted for race and gender both Ep and YEM correlated significantly (P < 0.05-0.0001) with age, BMI, waist, systolic and diastolic blood pressures, heart rate, product of heart rate and pulse pressure, triglycerides, total cholesterol to HDL cholesterol ratio, insulin and glucose. In a multivariate regression model that included hemodynamic variables, systolic blood pressure, product of heart rate and pulse pressure, age, triglycerides, BMI, and male gender (for YEM only) were independent correlates of Ep (R2 = 0.38) and YEM (R2 = 0.25). When the hemodynamic variables were excluded from the model, age, triglycerides, BMI, black race (Ep only), male gender, parental history of hypertension, HDL cholesterol (inverse association), and insulin (marginal significance) remained independent correlates of Ep (R2 = 0.20) and YEM (R2 = 16). Both Ep and YEM increased (P for trend P < 0.0001) with increasing number of independent continuous risk factors (defined as values above or below the age, race, and gender-specific extreme quintiles) that were retained in the regression models. The observed increasing arterial stiffness (or decreased elasticity) with increasing number of risk factors related to insulin resistance syndrome in free-living, asymptomatic young adults has important implications for prevention.

摘要

动脉弹性降低是心血管疾病的一个独立危险因素,在中老年人中与心血管危险因素相关。然而,关于年轻成年人这方面的信息有限。在一个基于社区的516名年龄在25 - 38岁的黑人和白人受试者样本(71%为白人,39%为男性)中对此进行了研究。通过M型超声测量颈总动脉弹性,得出彼得森弹性模量(Ep)和相对壁厚调整后的杨氏弹性模量(YEM)。黑人及男性的Ep较高(P < 0.05);男性的YEM较高(P < 0.0001);黑人的壁厚较高(P < 0.01)。对于经种族和性别调整的整个样本,Ep和YEM均与年龄、体重指数(BMI)、腰围、收缩压和舒张压、心率、心率与脉压的乘积、甘油三酯、总胆固醇与高密度脂蛋白胆固醇比值、胰岛素和血糖显著相关(P < 0.05 - 0.0001)。在一个包含血流动力学变量的多变量回归模型中,收缩压、心率与脉压的乘积、年龄、甘油三酯、BMI以及男性性别(仅针对YEM)是Ep(R2 = 0.38)和YEM(R2 = 0.25)的独立相关因素。当从模型中排除血流动力学变量时,年龄、甘油三酯、BMI、黑人种族(仅针对Ep)、男性性别、高血压家族史、高密度脂蛋白胆固醇(负相关)以及胰岛素(边缘显著性)仍然是Ep(R2 = 0.20)和YEM(R2 = 0.16)的独立相关因素。随着回归模型中保留的独立连续危险因素(定义为高于或低于年龄、种族和性别特异性极端五分位数的值)数量增加,Ep和YEM均升高(趋势P < 0.0001)。在自由生活、无症状的年轻成年人中观察到,随着与胰岛素抵抗综合征相关的危险因素数量增加,动脉僵硬度增加(或弹性降低),这对预防具有重要意义。

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