Juonala Markus, Järvisalo Mikko J, Mäki-Torkko Noora, Kähönen Mika, Viikari Jorma S A, Raitakari Olli T
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
Circulation. 2005 Sep 6;112(10):1486-93. doi: 10.1161/CIRCULATIONAHA.104.502161. Epub 2005 Aug 29.
Exposure to risk factors in childhood may have long-term influences on vascular function. We examined the relationship between risk factors identified in childhood and arterial elasticity assessed in adulthood.
Carotid artery compliance (CAC), Young's elastic modulus (YEM), and stiffness index (SI), 3 measures of large-artery elasticity, were assessed with noninvasive ultrasound in 2255 healthy white adults aged 24 to 39 years participating in a population-based cohort study and who had risk factor data available since childhood. In multivariate models, childhood obesity (skinfold thickness) predicted decreased CAC (P<0.001), increased YEM (P<0.01), and increased SI (P<0.01) in adulthood. Childhood blood pressure was inversely associated with CAC (P<0.001) and directly associated with YEM (P<0.001). The number of risk factors identified in childhood, which included high LDL cholesterol (at or above 80th percentile), elevated blood pressure, skinfold thickness, low HDL cholesterol (at or below 20th percentile), and smoking, was related inversely with CAC (P<0.001) and directly with YEM (P<0.001). These associations remained highly significant after adjustment for the number of risk factors identified in adulthood (P=0.005 for CAC and P<0.001 for YEM).
Cardiovascular risk factors identified in childhood and adolescence predict decreased carotid artery elasticity in adulthood. These data suggest that risk factors operating in early life may have sustained deleterious effects on arterial elasticity.
儿童时期暴露于风险因素可能对血管功能产生长期影响。我们研究了儿童时期确定的风险因素与成年期评估的动脉弹性之间的关系。
在一项基于人群的队列研究中，对2255名年龄在24至39岁的健康白人成年人进行了无创超声检查，评估了颈动脉顺应性（CAC）、杨氏弹性模量（YEM）和僵硬度指数（SI）这三种大动脉弹性指标，这些成年人自儿童时期就有风险因素数据。在多变量模型中，儿童期肥胖（皮褶厚度）预示成年期CAC降低（P<0.001）、YEM升高（P<0.01）和SI升高（P<0.01）。儿童期血压与CAC呈负相关（P<0.001），与YEM呈正相关（P<0.001）。儿童期确定的风险因素数量，包括高LDL胆固醇（处于或高于第80百分位数）、血压升高、皮褶厚度、低HDL胆固醇（处于或低于第20百分位数）和吸烟，与CAC呈负相关（P<0.001），与YEM呈正相关（P<0.001）。在对成年期确定的风险因素数量进行调整后，这些关联仍然非常显著（CAC为P=0.005，YEM为P<0.001）。
儿童期和青少年期确定的心血管风险因素预示成年期颈动脉弹性降低。这些数据表明，早年起作用的风险因素可能对动脉弹性产生持续的有害影响。
