Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
PLoS One. 2011;6(10):e26303. doi: 10.1371/journal.pone.0026303. Epub 2011 Oct 25.
In older adults, an independent association exists between impaired lung function and cardiovascular disease. This interaction might be related to the effects of aging and/or smoking. In order to explore possible childhood antecedents to this association, we hypothesized that decreased lung function and vascular stiffness might be related, in early life.
To determine the relationship between lung function and carotid augmentation index (AIx), a measure of vascular stiffness, in 8-year old children.
Data on brachial blood pressure, lung function (FEV(1), FVC, FEV(1)/FVC, obtained by spirometry) and carotid AIx75 (AIx standardised to an arbitrary heart rate of 75 beats per minute, obtained by applanation tonometry) was available in 249 community-based 8-year old children. These healthy children had been subjects in a randomised controlled trial of two interventions (omega-3 fatty acid supplementation and house-dust mite avoidance) to prevent asthma. Smoking in pregnancy and childhood environmental tobacco smoke (ETS) exposure was prospectively collected by questionnaire. The association between lung function and carotid AIx75 was assessed in multivariate models that included sex, height, smoking status during pregnancy, ETS exposure and randomisation groups (house dust mite avoidance and dietary intervention) as covariates.
In the fully adjusted models, Carotid AIx75 was independently associated with FEV1 (standardised β = -0.17,b = -6.72, partial R(2) = .02, p = 0.03), FVC (standardised β = -0.29, b = -9.31, partial R(2) = 0.04, p<0.001) and FEV1/FVC (standardised β = .13, b = 18.4, partial R(2) = 0.02, p = 0.04).
Lower lung volumes are associated with increased vascular stiffness at an early age. The interaction between lung function and vascular stiffness may thus represent more than just age-related alterations in both the pulmonary and vascular systems.
在老年人中,肺功能受损与心血管疾病之间存在独立的关联。这种相互作用可能与衰老和/或吸烟的影响有关。为了探讨这种关联可能存在的儿童期前因,我们假设在生命早期,肺功能下降和血管僵硬可能相关。
确定 8 岁儿童的肺功能与颈动脉增强指数(AIx)之间的关系,AIx 是血管僵硬的一种衡量指标。
在 249 名基于社区的 8 岁儿童中,获得了肱动脉血压、肺功能(FEV1、FVC、FEV1/FVC,通过肺活量计获得)和颈动脉 AIx75(通过平板压力测量法标准化至任意心率 75 次/分钟的 AIx)的数据。这些健康的儿童曾是两项干预措施(ω-3 脂肪酸补充和尘螨回避)预防哮喘的随机对照试验的对象。通过问卷调查前瞻性收集了妊娠期间吸烟和儿童期环境烟草烟雾(ETS)暴露情况。在包括性别、身高、妊娠期间吸烟状况、ETS 暴露和随机分组(尘螨回避和饮食干预)作为协变量的多变量模型中,评估了肺功能与颈动脉 AIx75 之间的关联。
在完全调整的模型中,颈动脉 AIx75 与 FEV1(标准化β=-0.17,b=-6.72,部分 R²=0.02,p=0.03)、FVC(标准化β=-0.29,b=-9.31,部分 R²=0.04,p<0.001)和 FEV1/FVC(标准化β=0.13,b=18.4,部分 R²=0.02,p=0.04)独立相关。
较低的肺活量与早期血管僵硬程度增加相关。因此,肺功能和血管僵硬之间的相互作用可能不仅仅代表肺部和血管系统随年龄的变化。