Verçoza Ana Maria, Baldisserotto Matteo, de Los Santos Carlos Abaeté, Poli-de-Figueiredo Carlos Eduardo, d'Avila Domingos Otavio
Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nefrologia), Faculdade de Medicina/IPB/HSL, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS 90016-000, Brazil.
Pediatr Cardiol. 2009 Nov;30(8):1055-60. doi: 10.1007/s00246-009-9493-3. Epub 2009 Jul 28.
Atherosclerosis, beginning in childhood, is dependent on several risk factors and may be predictive of coronary artery disease in adulthood. The risk factors for subclinical atherosclerosis are similar to those for clinical disease. Carotid intima-media thickness is a measure of subclinical atherosclerosis and a predictor of subsequent vascular events. This study aimed to examine the relationships of carotid intima-media thickness with known risk factors in asymptomatic children. Family history of cardiovascular disease was collected, together with anthropometric, demographic, and clinical data. Body mass index z-scores were calculated. Serum glucose, lipid fractions, fibrinogen, and C-reactive protein were determined. High-resolution ultrasonography was used to assess intima-media thickness. Associations and relationships of risk factors with composite intima-media thickness were explored. The study enrolled 93 children (44 girls) ranging in age from 49 to 169 months. The boys had a thicker intima-media (0.46 +/- 0.06 mm) than the girls (0.43 +/- 0.06 mm; p = 0.028). The unadjusted triglyceride levels were significantly higher in the overweight and obese children (p = 0.010). Body mass index and overweight/obesity were positively related to intima-media thickness (r = 0.259; p = 0.012 and r (s) = 0.230; p = 0.027, respectively), whereas family history of cardiovascular disease was unrelated. Only gender and overweight/obesity were related to intima-media thickness in a multiple linear regression model (R (2) = 0.125; p = 0.002). Male gender and overweight/obesity were associated with increased intima-media thickness, whereas family history of cardiovascular disease was unrelated.
动脉粥样硬化始于儿童期，取决于多种风险因素，可能预示成年期的冠状动脉疾病。亚临床动脉粥样硬化的风险因素与临床疾病的风险因素相似。颈动脉内膜中层厚度是亚临床动脉粥样硬化的一个指标，也是后续血管事件的预测指标。本研究旨在探讨无症状儿童颈动脉内膜中层厚度与已知风险因素之间的关系。收集了心血管疾病家族史以及人体测量、人口统计学和临床数据。计算了体重指数z评分。测定了血清葡萄糖、血脂成分、纤维蛋白原和C反应蛋白。采用高分辨率超声评估内膜中层厚度。探讨了风险因素与复合内膜中层厚度的关联和关系。该研究纳入了93名年龄在49至169个月之间的儿童（44名女孩）。男孩的内膜中层厚度（0.46±0.06毫米）比女孩（0.43±0.06毫米；p = 0.028）厚。超重和肥胖儿童的未调整甘油三酯水平显著更高（p = 0.010）。体重指数和超重/肥胖与内膜中层厚度呈正相关（r = 0.259；p = 0.012和r(s) = 0.230；p = 0.027），而心血管疾病家族史则无关联。在多元线性回归模型中，只有性别和超重/肥胖与内膜中层厚度有关（R(2) = 0.125；p = 0.002）。男性性别和超重/肥胖与内膜中层厚度增加有关，而心血管疾病家族史则无关联。
