Ayer Julian G, Harmer Jason A, Nakhla Shirley, Xuan Wei, Ng Martin K C, Raitakari Olli T, Marks Guy B, Celermajer David S
Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
Arterioscler Thromb Vasc Biol. 2009 Jun;29(6):943-9. doi: 10.1161/ATVBAHA.109.184184. Epub 2009 Apr 9.
Atherosclerosis is found at autopsy in the arteries of adolescents and young adults. Arterial wall thickening may be assessed in vivo by ultrasound measurement of the carotid intima media thickness (CIMT), a marker of subclinical atherosclerosis. As the determinants of arterial wall thickness in childhood are unknown, we assessed the influence of cardiovascular risk factors on CIMT in 8-year-old children.
A community-based sample of 405 children (age 8.0+/-0.1 years, 49% girls) had anthropometry, family history, blood pressure (BP), and CIMT measured. A blood sample was collected for HDL and non-HDL cholesterol, apolipoproteins A1 and B, high-sensitivity C-reactive protein, bilirubin, and asymmetric dimethylarginine (ADMA, an endogenous nitric oxide inhibitor). CIMT was significantly associated with systolic BP (r=0.17, P<0.001), diastolic BP (r=0.10, P=0.04), HDL (r=-0.13, P=0.02), and ADMA (r=0.18, P=0.001). CIMT was significantly higher in children with premature parental CHD (0.63+/-0.07 versus 0.59+/-0.06 mm, P=0.03). On multivariate analysis, HDL (beta coefficient=-0.02, P=0.04), ADMA (beta coefficient=0.05, P<0.001), and systolic BP (beta coefficient=0.001, P=0.003) were significantly and independently associated with CIMT.
Lower HDL-cholesterol, higher levels of ADMA, and systolic BP are significantly associated with greater arterial wall thickness in early childhood.
在青少年和青年成人的动脉尸检中发现存在动脉粥样硬化。动脉壁增厚可通过超声测量颈动脉内膜中层厚度（CIMT）进行体内评估，CIMT是亚临床动脉粥样硬化的一个标志物。由于儿童期动脉壁厚度的决定因素尚不清楚，我们评估了心血管危险因素对8岁儿童CIMT的影响。
对405名儿童（年龄8.0±0.1岁，49%为女孩）进行基于社区的抽样，测量其人体测量学指标、家族史、血压（BP）和CIMT。采集血样检测高密度脂蛋白和非高密度脂蛋白胆固醇、载脂蛋白A1和B、高敏C反应蛋白、胆红素以及不对称二甲基精氨酸（ADMA，一种内源性一氧化氮抑制剂）。CIMT与收缩压（r = 0.17，P < 0.001）、舒张压（r = 0.10，P = 0.04）、高密度脂蛋白（r = -0.13，P = 0.02）和ADMA（r = 0.18，P = 0.001）显著相关。父母患有早发性冠心病的儿童CIMT显著更高（0.63±0.07对0.59±0.06mm，P = 0.03）。多因素分析显示，高密度脂蛋白（β系数 = -0.02，P = 0.04）、ADMA（β系数 = 0.05，P < 0.001）和收缩压（β系数 = 0.001，P = 0.003）与CIMT显著且独立相关。
儿童早期，较低的高密度脂蛋白胆固醇、较高水平的ADMA和收缩压与更大的动脉壁厚度显著相关。
