肥胖高血压儿童及青少年内皮功能障碍、颈动脉内膜中层厚度与血管炎症循环标志物之间的关系

Relationship between endothelial dysfunction, carotid artery intima media thickness and circulating markers of vascular inflammation in obese hypertensive children and adolescents.

作者信息

Głowińska-Olszewska Barbara, Tołwińska Joanna, Urban Mirosława

机构信息

2nd Department of Children's Diseases, Medical University, Białystok, Poland.

出版信息

J Pediatr Endocrinol Metab. 2007 Oct;20(10):1125-36.

PMID:18051931

Abstract

BACKGROUND

Adhesion molecules released by dysfunctional endothelium are considered as markers of vascular inflammation in early atherosclerosis. Non-invasive ultrasound methods are now available to detect first preclinical signs of the disease.

AIM

To investigate the relationship between selected adhesion molecules and ultrasound indicators of early atherosclerosis: endothelial function measured by flow-mediated dilatation (FMD) and intima media thickness (IMT).

PATIENTS

The study group consisted of 85 children, mean age 14.6 years, of whom 22 were obese, 31 were hypertensive, and 32 obese and hypertensive. The control group included 26 healthy children.

METHODS

Adhesin concentrations were determined by ELISA. FMD and IMT were evaluated by ultrasound.

RESULTS

A positive correlation was found between sICAM-1 (soluble intercellular adhesion molecule 1) and IMT (r = 0.32, p = 0.013, 95% CI: 0.11 to 0.49) and a negative correlation between IMT and FMD (r = -0.26, p = 0.04, 95% CI: -0.43 to -0.04) in the whole study group. In the particular groups, we found significant correlations only in obese hypertensive children. sICAM-1 correlated positively with IMT (r = 0.52, p = 0.001, 95% CI: 0.2 to 0.72) and negatively with FMD (r = -0.31, p = 0.027, 95% CI: -0.6 to -0.2). sE-selectin correlated positively with IMT (r = 0.41, p = 0.012). In regression models, IMT correlated with sICAM-1 (beta = 0.37, p = 0.03) and body mass index (beta = 0.55, p = 0.02), and FMD correlated negatively with sICAM-1 (beta = -0.47, p = 0.04).

CONCLUSIONS

The association between inflammatory markers of the endothelium with impaired vasodilatation activity and the first atherosclerotic structural changes in the common carotid arteries were found in obese hypertensive children and adolescents. The coexistence of obesity and hypertension predisposes these young patients to closely related disturbances connected with early atherosclerosis.

摘要

背景

功能失调的内皮细胞释放的黏附分子被认为是早期动脉粥样硬化中血管炎症的标志物。现在有非侵入性超声方法可用于检测该疾病的首个临床前体征。

目的

研究选定的黏附分子与早期动脉粥样硬化的超声指标之间的关系：通过血流介导的血管舒张（FMD）测量的内皮功能和内膜中层厚度（IMT）。

患者

研究组由85名儿童组成，平均年龄14.6岁，其中22名肥胖，31名高血压，32名肥胖且高血压。对照组包括26名健康儿童。

方法

通过酶联免疫吸附测定法测定黏附素浓度。通过超声评估FMD和IMT。

结果

在整个研究组中，可溶性细胞间黏附分子1（sICAM-1）与IMT之间呈正相关（r = 0.32，p = 0.013，95%可信区间：0.11至0.49），IMT与FMD之间呈负相关（r = -0.26，p = 0.04，95%可信区间：-0.43至-0.04）。在特定组中，我们仅在肥胖高血压儿童中发现了显著相关性。sICAM-1与IMT呈正相关（r = 0.52，p = 0.001，95%可信区间：0.2至0.72），与FMD呈负相关（r = -0.31，p = 0.027，95%可信区间：-0.6至-0.2）。可溶性E选择素与IMT呈正相关（r = 0.41，p = 0.012）。在回归模型中，IMT与sICAM-1（β = 0.37，p = 0.03）和体重指数（β = 0.55，p = 例：0.02）相关联，FMD与sICAM-1呈负相关（β = -0.47，p = 0.04）。