Juonala Markus, Viikari Jorma S A, Kähönen Mika, Solakivi Tiina, Helenius Hans, Jula Antti, Marniemi Jukka, Taittonen Leena, Laitinen Tomi, Nikkari Tapio, Raitakari Olli T
Department of Medicine, University of Turku, Turku, Finland.
J Am Coll Cardiol. 2008 Jul 22;52(4):293-9. doi: 10.1016/j.jacc.2008.03.054.
The aim of this study was to determine whether apolipoproteins (apo) B and A-I measured in childhood and adolescence predict atherosclerosis in adulthood.
Exposure to dyslipidemia in childhood predicts the development of atherosclerosis. Apolipoproteins B and A-I might be good markers of atherogenic dyslipidemia, but there is a paucity of information concerning their importance in childhood.
Apolipoproteins B and A-I, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides, blood pressure, obesity, insulin, C-reactive protein, and smoking were assessed in 1980 and 2001 among 879 subjects in the Cardiovascular Risk in Young Finns Study (ages 3 to 18 years at baseline). Carotid artery intima-media thickness (IMT) and brachial artery flow-mediated dilation (FMD) were measured in 2001 at the age of 24 to 39 years.
In subjects ages 12 to 18 years at baseline, apoB and apoB/apoA-I ratio were directly (p < 0.001) related and apoA-I was inversely (p = 0.01) related with adulthood IMT. In subjects ages 3 to 18 years at baseline, apoB (p = 0.02) and the apoB/apoA-I ratio (p < 0.001) were inversely related and apoA-I (p = 0.003) was directly related to adulthood FMD. These relations were not altered when the effects of nonlipid risk factors and adulthood apolipoproteins were taken into account. The apoB/apoA-I ratio measured in adolescence was superior to LDL/HDL ratio (c-values, 0.623 vs. 0.569, p = 0.03) in predicting increased IMT in adulthood (IMT >or=90th percentile and/or carotid plaque).
Apolipoproteins B and A-I measured in children and adolescents reflect a lipoprotein profile predisposing to the development of subclinical atherosclerosis in adulthood. These markers might have value in pediatric lipid risk assessment.
本研究旨在确定儿童期和青少年期测量的载脂蛋白（apo）B和A-I是否能预测成年期的动脉粥样硬化。
儿童期暴露于血脂异常可预测动脉粥样硬化的发展。载脂蛋白B和A-I可能是致动脉粥样硬化性血脂异常的良好标志物，但关于它们在儿童期的重要性的信息却很少。
在芬兰年轻人心血管风险研究中，于1980年和2001年对879名受试者（基线年龄为3至18岁）评估了载脂蛋白B和A-I、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇、甘油三酯、血压、肥胖、胰岛素、C反应蛋白和吸烟情况。2001年，在受试者24至39岁时测量了颈动脉内膜中层厚度（IMT）和肱动脉血流介导的舒张功能（FMD）。
在基线年龄为12至18岁的受试者中，apoB和apoB/apoA-I比值呈正相关（p < 0.001），而apoA-I与成年期IMT呈负相关（p = 0.01）。在基线年龄为3至18岁的受试者中，apoB（p = 0.02）和apoB/apoA-I比值（p < 0.001）呈负相关，而apoA-I（p = 0.003）与成年期FMD呈正相关。在考虑了非脂质危险因素和成年期载脂蛋白的影响后，这些关系并未改变。在预测成年期IMT增加（IMT≥第90百分位数和/或颈动脉斑块）方面，青少年期测量的apoB/apoA-I比值优于LDL/HDL比值（c值分别为0.623和0.569，p = 0.03）。
儿童和青少年期测量的载脂蛋白B和A-I反映了一种脂蛋白谱，这种脂蛋白谱易导致成年期亚临床动脉粥样硬化的发展。这些标志物可能在儿童脂质风险评估中有价值。
