Toledo-Corral Claudia M, Ventura Emily E, Hodis Howard N, Weigensberg Marc J, Lane Christianne J, Li Yanjie, Goran Michael I
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089-9073, United States.
Atherosclerosis. 2009 Oct;206(2):594-8. doi: 10.1016/j.atherosclerosis.2009.03.013. Epub 2009 Mar 25.
The objective of this study was to examine the influence of persistence of the metabolic syndrome (Mets) and its individual components over a 3-year period on carotid intima media thickness (CIMT) in overweight Latino children.
Ninety-seven healthy male and female overweight Latino children (mean age at baseline: 11.0+/-1.8 years) were assessed for MetS on four annual evaluations and classified according to the persistence of MetS: NEVER (0 annual visits with the MetS, n=53), INTERMITTENT (1 or 2 visits with the MetS, n=28), and PERSISTENT (3 or 4 visits with the MetS, n=16). CIMT was measured with high-resolution B-mode ultrasound (7.9+/-0.7 months after the most recent MetS assessment; mean age: 14.6+/-1.8 years).
PERSISTENT MetS was associated with significantly higher CIMT (0.647+/-0.018mm compared to 0.600+/-0.007mm in those who NEVER had MetS, p<0.01). This difference remained significant after controlling for gender, baseline age, total fat mass, total lean tissue mass and insulin sensitivity. PERSISTENT high waist circumference and PERSISTENT high blood pressure were also significantly associated with higher mean CIMT, but these differences were no longer significant after controlling for total fat and lean tissue mass. Baseline systolic blood pressure and 2-h glucose were significantly related to CIMT independent of all other MetS components (p<0.05).
Persistence of the MetS over a 3-year period was uniquely associated with increased CIMT during childhood. Children with hypertension, persistent abdominal adiposity or impaired glucose tolerance may also be at higher risk for elevated CIMT.
本研究旨在探讨超重拉丁裔儿童中代谢综合征(Mets)及其各个组分持续3年对颈动脉内膜中层厚度(CIMT)的影响。
对97名健康的超重拉丁裔儿童(基线平均年龄:11.0±1.8岁)进行了四次年度代谢综合征评估,并根据代谢综合征的持续情况进行分类:从未发生(0次年度评估出现代谢综合征,n = 53)、间歇性发生(1或2次评估出现代谢综合征,n = 28)和持续性发生(3或4次评估出现代谢综合征,n = 16)。采用高分辨率B型超声测量CIMT(在最近一次代谢综合征评估后7.9±0.7个月;平均年龄:14.6±1.8岁)。
持续性代谢综合征与显著更高的CIMT相关(0.647±0.018mm,而从未发生代谢综合征的儿童为0.600±0.007mm,p<0.01)。在控制性别、基线年龄、总脂肪量、总瘦组织量和胰岛素敏感性后,这种差异仍然显著。持续性高腰围和持续性高血压也与更高的平均CIMT显著相关,但在控制总脂肪和瘦组织量后,这些差异不再显著。基线收缩压和2小时血糖与CIMT显著相关,独立于所有其他代谢综合征组分(p<0.05)。
代谢综合征持续3年与儿童期CIMT增加有独特关联。患有高血压、持续性腹部肥胖或糖耐量受损的儿童CIMT升高的风险也可能更高。