Bhuiyan Azad R, Srinivasan Sathanur R, Chen Wei, Paul Timir K, Berenson Gerald S
Tulane Center for Cardiovascular Health, Tulane University Health Sciences Center, New Orleans, LA 70112, USA.
Atherosclerosis. 2006 Nov;189(1):1-7. doi: 10.1016/j.atherosclerosis.2006.02.011. Epub 2006 Mar 29.
Adverse changes in arterial structure and function, independent predictors of cardiovascular (CV) disease morbidity and mortality, are known to be associated with CV risk factors, especially in middle-aged and older adults. Although non-invasive studies in this regard are beginning to emerge in a younger age population, information is lacking on the correlates of measures of vascular structure and function obtained simultaneously by different non-invasive methods.
In 518 black and white subjects (72% white, 44% male) aged 27-43 years, vascular structure and function were measured in terms of (1) carotid artery intima-media thickness (IMT), (2) aorta-femoral pulse wave velocity (af-PWV), and (3) pulsatile arterial function in terms of large (C1) and small (C2) artery compliances.
Blacks versus whites and males versus females had higher carotid IMT; blacks versus whites higher af-PWV; and blacks versus whites and females versus males lower C1 and C2. In a multivariate regression model, significant predictors in the order of entry into the model were systolic blood pressure, male gender, age, cigarette smoking, and LDL cholesterol for carotid IMT (R(2)=0.189); systolic blood pressure, homeostasis model assessment of insulin resistance (HOMA-IR), cigarette smoking, and age for af-PWV (R(2)=0.200); systolic blood pressure, female gender, and HOMA-IR for C1 (R(2)=0.258); and systolic blood pressure, female gender, age, diastolic blood pressure, cigarette smoking, triglycerides, and black race for C2 (R(2)=0.394).
In asymptomatic young adults, CV risk factors influence adversely measures of both structure and function of the vasculature to varying degrees, with small artery compliance showing maximum variance. As part of preventive cardiology, assessment of structure/function measures of the vasculature by simple non-invasive methods may be helpful in identifying early vascular damage in a high-risk young population group.
动脉结构和功能的不良变化是心血管（CV）疾病发病和死亡的独立预测因素，已知与CV危险因素相关，尤其是在中老年人中。尽管这方面的非侵入性研究开始在较年轻人群中出现，但缺乏关于通过不同非侵入性方法同时获得的血管结构和功能测量指标相关性的信息。
在518名年龄在27 - 43岁的黑人和白人受试者（72%为白人，44%为男性）中，从以下方面测量血管结构和功能：（1）颈动脉内膜中层厚度（IMT）；（2）主动脉-股动脉脉搏波速度（af-PWV）；（3）根据大动脉（C1）和小动脉（C2）顺应性测量的搏动性动脉功能。
黑人与白人相比，男性与女性相比，颈动脉IMT更高；黑人与白人相比，af-PWV更高；黑人与白人相比，女性与男性相比，C1和C2更低。在多变量回归模型中，按进入模型的顺序，颈动脉IMT的显著预测因素依次为收缩压、男性性别、年龄、吸烟和低密度脂蛋白胆固醇（R² = 0.189）；af-PWV的显著预测因素依次为收缩压、胰岛素抵抗的稳态模型评估（HOMA-IR）、吸烟和年龄（R² = 0.200）；C1的显著预测因素依次为收缩压、女性性别和HOMA-IR（R² = 0.258）；C2的显著预测因素依次为收缩压、女性性别、年龄、舒张压、吸烟、甘油三酯和黑人种族（R² = 0.394）。
在无症状的年轻成年人中，CV危险因素对血管系统的结构和功能测量指标有不同程度的不良影响，小动脉顺应性的变化最大。作为预防心脏病学的一部分，通过简单的非侵入性方法评估血管系统的结构/功能测量指标可能有助于识别高危年轻人群中的早期血管损伤。
