Juonala Markus, Kähönen Mika, Laitinen Tomi, Hutri-Kähönen Nina, Jokinen Eero, Taittonen Leena, Pietikäinen Matti, Helenius Hans, Viikari Jorma S A, Raitakari Olli T
Department of Medicine, University of Turku, PO Box 52, 20521 Turku, Finland.
Eur Heart J. 2008 May;29(9):1198-206. doi: 10.1093/eurheartj/ehm556. Epub 2007 Dec 12.
The objective was to produce reference values and to analyse the associations of age and sex with carotid intima-media thickness (IMT), carotid compliance (CAC), and brachial flow-mediated dilatation (FMD) in young healthy adults.
We measured IMT, CAC, and FMD with ultrasound in 2265 subjects aged 24-39 years. The mean values (mean +/- SD) in men and women were 0.592 +/- 0.10 vs. 0.572 +/- 0.08 mm (P < 0.0001) for IMT, 2.00 +/- 0.66 vs. 2.31 +/- 0.77%/10 mmHg (P < 0.0001) for CAC, and 6.95 +/- 4.00 vs. 8.83 +/- 4.56% (P < 0.0001) for FMD. The sex differences in IMT [95% confidence interval (CI) for sex difference -0.013 to 0.004 mm, P = 0.37] and CAC (-0.01 to 0.18%/10 mmHg, P = 0.09) became non-significant after adjustments with risk factors and carotid diameter. In FMD, the sex difference was unaltered after adjustments for risk factors, but was reversed after adjustment with brachial diameter (95% CI 0.18-1.32%, P < 0.01). With aging, IMT increased 5.7 +/- 0.4 microm/year and CAC decreased 0.042 +/- 0.003%/10 mmHg/year. The association of age with IMT and CAC was slightly attenuated (12 and 22%, respectively) after adjustments with risk factors, but remained significant (both P < 0.0001). Aging was not significantly related to brachial FMD (P = 0.16).
Reference values produced in the present study can be utilized in the cardiovascular risk stratification among young people. Sex differences in the markers of subclinical atherosclerosis were mostly explained by differences in risk factors and vessel size. This emphasizes the importance of risk factor control in the prevention of atherosclerosis in young adults.
本研究旨在得出年轻健康成年人的参考值，并分析年龄和性别与颈动脉内膜中层厚度（IMT）、颈动脉顺应性（CAC）以及肱动脉血流介导的血管舒张功能（FMD）之间的关联。
我们对2265名年龄在24 - 39岁的受试者进行了超声检查，测量其IMT、CAC和FMD。男性和女性的IMT平均值（均值±标准差）分别为0.592±0.10与0.572±0.08毫米（P < 0.0001），CAC分别为2.00±0.66与2.31±0.77%/10 mmHg（P < 0.0001），FMD分别为6.95±4.00与8.83±4.56%（P < 0.0001）。在校正危险因素和颈动脉直径后，IMT[性别差异的95%置信区间（CI）为 - 0.013至0.004毫米，P = 0.37]和CAC（ - 0.01至0.18%/10 mmHg，P = 0.09）的性别差异不再显著。在FMD方面，校正危险因素后性别差异未改变，但校正肱动脉直径后差异反转（95% CI为0.18 - 1.32%，P < 0.01）。随着年龄增长，IMT每年增加5.7±0.4微米，CAC每年降低0.042±0.003%/10 mmHg。在校正危险因素后，年龄与IMT和CAC的关联略有减弱（分别减弱12%和22%），但仍具有显著性（P均< 0.0001）。年龄增长与肱动脉FMD无显著相关性（P = 0.16）。
本研究得出的参考值可用于年轻人的心血管风险分层。亚临床动脉粥样硬化标志物的性别差异大多可由危险因素和血管大小的差异来解释。这强调了控制危险因素在预防年轻成年人动脉粥样硬化中的重要性。
