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股动脉内膜中层厚度增加的无症状健康年轻成年人的心血管风险概况:博加卢萨心脏研究

Cardiovascular risk profile of asymptomatic healthy young adults with increased femoral artery intima-media thickness: The Bogalusa Heart Study.

作者信息

Paul Timir K, Srinivasan Sathanur R, Wei Chen, Li Shengxu, Bhuiyan Azad R, Bond M Gene, Tang Rong, Berenson Gerald S

机构信息

Tulane Center for Cardiovascular Health, Tulane University Health Sciences Center, New Orleans, Louisiana 70112, USA.

出版信息

Am J Med Sci. 2005 Sep;330(3):105-10. doi: 10.1097/00000441-200509000-00001.

Abstract

BACKGROUND

Femoral artery intima-media thickness (IMT), like carotid IMT, is a surrogate indicator of atherosclerotic coronary and peripheral vascular diseases in middle-aged and older adults. This study examined the cardiovascular disease risk profile of asymptomatic young adults with increased femoral artery IMT.

METHODS

Femoral artery IMT was measured by B-mode ultrasonography in 1080 black and white subjects (aged 24-43 years; 71% white, 43% male) enrolled in the Bogalusa Heart Study. Individuals in the top (n=54) versus bottom fifth (n=54) percentiles distribution of femoral IMT were compared for traditional cardiovascular risk factors profile. Univariate analysis compared the two groups, t-tests and chi tests were performed.

RESULTS

The top and bottom fifth percentiles of IMT differed with respect to age (P<0.001), systolic blood pressure (P<0.05), diastolic blood pressure (P<0.05), total cholesterol (P<0.01), low-density lipoprotein (LDL) cholesterol (P<0.001), non-high-density lipoprotein (HDL) cholesterol (P<0.01) and smoking status (P<0.01). In terms of prevalence of clinically defined traditional risk factors, individuals at the top versus bottom fifth percentile of IMT distribution had significantly higher prevalence of high LDL cholesterol (>OR=130 mg/dL), non-HDL cholesterol (>OR=160 mg/dL), and cigarette smoking. The odds ratio for individuals with three or more risk factors versus no risk factors having IMT in the top fifth percentile was 4.7 (P=0.01).

CONCLUSION

The observed adverse effect of cardiovascular risk factors on IMT of femoral artery, a surrogate measure of coronary and peripheral atherosclerosis, in asymptomatic young individuals underscores the need for risk factors profiling in early life. These observations have important implications in preventive medicine.

摘要

背景

股动脉内膜中层厚度(IMT)与颈动脉IMT一样,是中老年人群动脉粥样硬化性冠状动脉疾病和外周血管疾病的替代指标。本研究调查了股动脉IMT增加的无症状年轻成年人的心血管疾病风险状况。

方法

在参加博加卢萨心脏研究的1080名黑人和白人受试者(年龄24 - 43岁;71%为白人,43%为男性)中,通过B型超声测量股动脉IMT。比较股动脉IMT分布处于最高五分位数(n = 54)和最低五分位数(n = 54)的个体的传统心血管危险因素状况。采用单因素分析比较两组,进行t检验和卡方检验。

结果

IMT的最高和最低五分位数在年龄(P < 0.001)、收缩压(P < 0.05)、舒张压(P < 0.05)、总胆固醇(P < 0.01)、低密度脂蛋白(LDL)胆固醇(P < 0.001)、非高密度脂蛋白(HDL)胆固醇(P < 0.01)和吸烟状况(P < 0.01)方面存在差异。就临床定义的传统危险因素的患病率而言,IMT分布处于最高五分位数的个体与最低五分位数的个体相比,高LDL胆固醇(> 130 mg/dL)、非HDL胆固醇(> 160 mg/dL)和吸烟的患病率显著更高。具有三个或更多危险因素的个体与无危险因素且IMT处于最高五分位数的个体的比值比为4.7(P = 0.01)。

结论

在无症状的年轻个体中,观察到心血管危险因素对股动脉IMT(冠状动脉和外周动脉粥样硬化的替代指标)有不良影响,这突出了在生命早期进行危险因素分析的必要性。这些观察结果对预防医学具有重要意义。

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