Dietrich Andrea, Riese Harriëtte, van Roon Arie M, van Engelen Klaartje, Ormel Johan, Neeleman Jan, Rosmalen Judith G M
Graduate School of Behavioral and Cognitive Neurosciences, Department of Psychiatry, University of Maastricht, Maastricht, The Netherlands.
J Hypertens. 2006 Feb;24(2):345-52. doi: 10.1097/01.hjh.0000200517.27356.47.
To present normal spontaneous baroreflex sensitivity (BRS) values and investigate the influence of posture, sex, age, pubertal stage, body mass index (BMI), and physical activity level on BRS in (pre)adolescents. BRS is a sensitive measure of both sympathetic and parasympathetic cardiovascular regulation that may help detect early subclinical autonomic dysfunction.
A cross-sectional cohort study in a large sample of 10-13-year-old Dutch (pre)adolescents from the general population.
Short-term spontaneous BRS was determined non-invasively by Portapres in both the supine and standing position. BRS was calculated by power spectral analysis using the discrete Fourier method (frequency band 0.07-0.14 Hz). Univariate statistical methods and multiple regression analyses were applied.
BRS in a standing position was lower than in a supine position (9.0 +/- 4.9 versus 15.3 +/- 9.1 ms/mmHg; t = 27.8, P < 0.001). Girls had lower BRS values than boys in both postures (supine 14.3 +/- 8.7 versus 16.4 +/- 9.4 ms/mmHg, beta = 0.12, P < 0.001; standing 8.4 +/- 4.4 versus 9.5 +/- 5.4 ms/mmHg, beta = 0.08, P = 0.012), independent of age, pubertal stage, BMI, and physical activity. Lower limits (P2.5) for normal BRS values in supine and standing positions were for girls 3.6 and 2.2 ms/mmHg and for boys 3.9 and 2.5 ms/mmHg, respectively. BRS declined with age in the standing position (beta = -0.13, P < 0.001). In obese (pre)adolescents, BMI was negatively associated with BRS during standing (Kendall's tau = -0.26, P = 0.010).
The BRS of (pre)adolescents was negatively related to female sex, age, and obesity. A reduced BRS in obese (pre)adolescents might be a candidate predictor of future cardiovascular health, and therefore warrants further exploration.
呈现正常的自发性压力反射敏感性（BRS）值，并研究姿势、性别、年龄、青春期阶段、体重指数（BMI）和身体活动水平对（青春期前）青少年BRS的影响。BRS是交感神经和副交感神经心血管调节的一项敏感指标，有助于检测早期亚临床自主神经功能障碍。
对来自普通人群的大量10至13岁荷兰（青春期前）青少年进行横断面队列研究。
使用Portapres在仰卧位和站立位无创测定短期自发性BRS。采用离散傅里叶方法（频段0.07 - 0.14Hz）通过功率谱分析计算BRS。应用单变量统计方法和多元回归分析。
站立位的BRS低于仰卧位（9.0±4.9对15.3±9.1ms/mmHg；t = 27.8，P < 0.001）。在两种姿势下，女孩的BRS值均低于男孩（仰卧位14.3±8.7对16.4±9.4ms/mmHg，β = 0.12，P < 0.001；站立位8.4±4.4对9.5±5.4ms/mmHg，β = 0.08，P = 0.012），且不受年龄、青春期阶段、BMI和身体活动的影响。仰卧位和站立位正常BRS值的下限（P2.5），女孩分别为3.6和2.2ms/mmHg，男孩分别为3.9和2.5ms/mmHg。站立位时，BRS随年龄下降（β = -0.13，P < 0.001）。在肥胖（青春期前）青少年中，站立时BMI与BRS呈负相关（肯德尔tau系数= -0.26，P = 0.010）。
（青春期前）青少年的BRS与女性性别、年龄和肥胖呈负相关。肥胖（青春期前）青少年BRS降低可能是未来心血管健康的一个潜在预测指标，因此值得进一步探索。
