Ranadive Sushant M, Yan Huimin, Weikert Madeline, Lane Abbi D, Linden Mellissa A, Baynard Tracy, Motl Robert W, Fernhall Bo
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
Med Sci Sports Exerc. 2012 Feb;44(2):238-43. doi: 10.1249/MSS.0b013e31822d7997.
Multiple sclerosis (MS) is an inflammatory disorder of the brain and spinal cord. Disability status and progression are associated with reduced physical activity (PA) and cardiovascular function. Lack of adequate PA combined with inflammation may create high susceptibility to subclinical atherosclerosis and vascular dysfunction.
The purpose of this study was to compare subclinical atherosclerosis and arterial function between individuals with and without MS matched for age, sex, and body mass index.
Thirty-three individuals diagnosed with MS and 33 controls underwent strain gauge plethysmography for resting forearm blood flow (FBF) and peak reactive hyperemia for the microvascular function. Intima-media thickness and arterial compliance (AC) were measured using carotid ultrasound for vascular function. C-reactive protein and PA (7-d accelerometer data) were also measured.
There was a significant difference (P < 0.05) in resting FBF, peak reactive hyperemia, central pulse wave velocity, and AC between the MS and control groups. PA was associated with peak FBF and central pulse wave velocity but not FBF and carotid AC. Individuals with MS exhibit reduced arterial function but similar intima-media thickness compared with controls. Persons with MS had significantly reduced PA levels compared with controls, and PA accounted for differences in arterial function between groups.
These results indicate that subclinical markers of atherosclerosis are higher in individuals with MS, suggesting a higher risk of cardiovascular disease in this population. However, the higher levels of subclinical atherosclerosis were accounted for by the low PA in persons with MS, suggesting that increasing PA may reduce the increase in cardiovascular disease risk in patients with MS.
多发性硬化症（MS）是一种脑和脊髓的炎症性疾病。残疾状态和病情进展与身体活动（PA）减少及心血管功能下降有关。缺乏足够的身体活动并伴有炎症可能会使个体对亚临床动脉粥样硬化和血管功能障碍高度易感。
本研究的目的是比较年龄、性别和体重指数相匹配的患MS个体与未患MS个体之间的亚临床动脉粥样硬化和动脉功能。
33名被诊断为MS的个体和33名对照者接受了应变片体积描记法以测量静息前臂血流量（FBF），并接受了用于微血管功能的峰值反应性充血测量。使用颈动脉超声测量内膜中层厚度和动脉顺应性（AC）以评估血管功能。还测量了C反应蛋白和身体活动（7天加速度计数据）。
MS组和对照组在静息FBF、峰值反应性充血、中心脉搏波速度和AC方面存在显著差异（P < 0.05）。身体活动与峰值FBF和中心脉搏波速度相关，但与FBF和颈动脉AC无关。与对照组相比，患MS的个体动脉功能降低，但内膜中层厚度相似。与对照组相比，患MS的个体身体活动水平显著降低，且身体活动解释了两组之间动脉功能的差异。
这些结果表明，患MS个体的动脉粥样硬化亚临床标志物更高，提示该人群心血管疾病风险更高。然而，MS患者亚临床动脉粥样硬化水平较高是由其低身体活动水平所致，这表明增加身体活动可能会降低MS患者心血管疾病风险的增加。
