Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
Pediatrics. 2011 Feb;127(2):e312-8. doi: 10.1542/peds.2010-1125. Epub 2011 Jan 17.
Cardiovascular risk assessment is an accepted practice in adults and correlates with early changes in carotid structure and function. Its clinical use in pediatrics is less common. We sought to determine whether a simple method of clustering cardiovascular risks could detect early atherosclerotic changes in youth. In addition, we compared risk clustering with the accepted Patholobiological Determinants of Atherosclerosis in Youth score to assess its utility for predicting early vascular disease.
We collected demographic, anthropometric, laboratory, and vascular measures in a cross-sectional study. The study population (n = 474; mean age: 18 years) was divided into low-risk (0-1) or high-risk (≥ 2) groups on the basis of the number of cardiovascular risk factors present at evaluation. Group differences and vascular outcomes were compared. General linear models were used to compare clustering cardiovascular risks with the Patholobiological Determinants of Atherosclerosis in Youth score.
The high-risk group had higher vascular thickness and stiffness compared with the low-risk group (P < .05). Regression models found that clustering cardiovascular risks is associated with abnormal vascular structure and function after adjustment for age, race, and gender. The Patholobiological Determinants of Atherosclerosis in Youth score also is associated with abnormal vascular structure and function but with lower R(2) values (P < .05).
Cardiovascular risk clustering is a reliable tool for assessing abnormal vascular function. Its simplicity, compared with the Patholobiological Determinants of Atherosclerosis in Youth score, provides an advantageous tool for the practicing clinician to identify those youth who are at higher risk for early cardiovascular disease.
心血管风险评估在成年人中是一种被接受的做法，与颈动脉结构和功能的早期变化相关。它在儿科中的临床应用较少。我们旨在确定一种简单的心血管风险聚类方法是否可以检测到青少年的早期动脉粥样硬化变化。此外，我们比较了风险聚类与公认的青少年动脉粥样硬化病理生物学危险因素评分，以评估其预测早期血管疾病的效用。
我们在一项横断面研究中收集了人口统计学、人体测量学、实验室和血管测量数据。根据评估时存在的心血管危险因素数量，将研究人群（n=474；平均年龄：18 岁）分为低危（0-1）或高危（≥2）组。比较了组间差异和血管结果。使用一般线性模型比较聚类心血管风险与青少年动脉粥样硬化病理生物学危险因素评分。
高危组的血管厚度和僵硬度高于低危组（P<.05）。回归模型发现，在调整年龄、种族和性别后，聚类心血管风险与异常血管结构和功能相关。青少年动脉粥样硬化病理生物学危险因素评分也与异常血管结构和功能相关，但 R²值较低（P<.05）。
心血管风险聚类是评估异常血管功能的可靠工具。与青少年动脉粥样硬化病理生物学危险因素评分相比，其简单性为临床医生提供了一种有利的工具，可识别那些早期心血管疾病风险较高的青少年。
