健康年轻成年人血管损伤的无创动脉测量：与冠心病风险的关系。

Noninvasive arterial measurements of vascular damage in healthy young adults: relation to coronary heart disease risk.

作者信息

Van Trijp Marijke J C A, Uiterwaal Cuno S P M, Bos Willem J W, Oren Anath, Grobbee Diederick E, Bots Michiel L

机构信息

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, and Dept. of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.

出版信息

Ann Epidemiol. 2006 Feb;16(2):71-7. doi: 10.1016/j.annepidem.2005.09.005. Epub 2005 Nov 21.

DOI:10.1016/j.annepidem.2005.09.005

PMID:16305824

Abstract

PURPOSE

There is an increasing interest in noninvasive measurements of early structural or functional changes in large arteries such as pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and augmentation index (AIx). These measurements may be applied in etiologic or prognostic research. The role of the AIx as a marker of cardiovascular risk has not fully been established. Our aim was to study whether AIx is related to coronary heart disease (CHD) risk and to compare the strength of the relations of AIx, PWV, and CIMT with cardiovascular risk in healthy young adults.

METHODS

Our study included 224 men and 273 women (mean age 28 years, range 27-30 years) from the Atherosclerosis Risk in Young Adults (ARYA) study. Cardiovascular risk profile was determined and CHD risk was estimated using the Framingham risk score. AIx, PWV and CIMT were measured using standard methods. Data were analyzed in strata of gender using linear regression models.

RESULTS

In men, PWV and CIMT were most strongly related to CHD risk. The increase in CHD risk per standard deviation increase in measurement was 0.24%/m/s, 95% CI (0.01;0.33) and 0.32%/mm, 95% CI (0.08;0.55), whereas the AIx was not significantly related to CHD risk (0.09 %/% 95% CI [-0.15;0.33]). In women, AIx, PWV, and CIMT were weakly but significantly related to CHD risk; there was no clear difference between the measurements.

CONCLUSION

In young men, PWV and CIMT are better measures of CHD risk than AIx. In women, AIx, PWV and CIMT estimate CHD risk equally well.

摘要

目的

人们对诸如脉搏波速度（PWV）、颈动脉内膜中层厚度（CIMT）和增强指数（AIx）等大动脉早期结构或功能变化的无创测量越来越感兴趣。这些测量可应用于病因学或预后研究。AIx作为心血管风险标志物的作用尚未完全确立。我们的目的是研究AIx是否与冠心病（CHD）风险相关，并比较AIx、PWV和CIMT与健康年轻成年人心血管风险之间关系的强度。

方法

我们的研究纳入了来自年轻成年人动脉粥样硬化风险（ARYA）研究的224名男性和273名女性（平均年龄28岁，范围27 - 30岁）。确定心血管风险概况，并使用弗雷明汉风险评分估计冠心病风险。使用标准方法测量AIx、PWV和CIMT。使用线性回归模型按性别分层分析数据。

结果

在男性中，PWV和CIMT与冠心病风险的相关性最强。测量值每增加一个标准差，冠心病风险增加分别为0.24%/m/s，95%可信区间（0.01；0.33）和0.32%/mm，95%可信区间（0.08；0.55），而AIx与冠心病风险无显著相关性（0.09 %/%，95%可信区间[-0.15；0.33]）。在女性中，AIx、PWV和CIMT与冠心病风险呈弱但显著的相关性；各测量值之间无明显差异。