Norwegian University of Science and Technology, Trondheim, Norway.
Eur J Prev Cardiol. 2013 Aug;20(4):531-40. doi: 10.1177/2047487312444234. Epub 2012 Mar 28.
Endothelial dysfunction is an important marker for prognosis in patients with coronary heart disease. However, there are no reference values for endothelial function in a healthy population. Our aim was to determine the distribution of flow-mediated dilation (FMD) values by gender and age in healthy adults.
FMD was measured by ultrasound during reactive hyperaemia in the brachial artery of 4739 adults aged 20-89 years, who were free from self-reported cardiovascular or pulmonary disease. Differences in FMD across age and gender were analysed by multiple linear regression.
Total mean ± SD FMD was 4.8 ± 4.2%, with corresponding estimates of 4.3 ± 3.9% for men and 5.3 ± 4.5% for women (p < 0.001). In total, 17% had FMD ≤0%, indicating endothelial dysfunction. FMD decreased with increasing age in both genders up to 70 years for men and 80 for women (p < 0.001). In women, age-related decline in FMD was steepest after age 45; in men, a steady decline after age 30. In men 80 years and older, FMD was higher than in men aged 50-79 years.
The distribution of FMD in this study is representative of the respective age and gender groups of a healthy population and may be a useful reference for future studies. The high proportion of endothelial dysfunction came as a surprise. Its age and gender distribution suggest that FMD ≤0% precedes cardiovascular disease and that it may be a powerful non-invasive biomarker for identifying high-risk individuals.
内皮功能障碍是冠心病患者预后的一个重要标志物。然而，健康人群的内皮功能尚无参考值。我们的目的是确定健康成年人中血流介导的舒张（FMD）值的性别和年龄分布。
在 4739 名年龄在 20-89 岁、无自述心血管或肺部疾病的成年人的肱动脉中，通过超声测量反应性充血期间的 FMD。通过多元线性回归分析年龄和性别对 FMD 的差异。
总平均±SD 的 FMD 为 4.8±4.2%，男性为 4.3±3.9%，女性为 5.3±4.5%（p<0.001）。总共有 17%的人 FMD≤0%，表明存在内皮功能障碍。在两性中，FMD 随年龄增长而降低，男性至 70 岁，女性至 80 岁（p<0.001）。在女性中，45 岁以后 FMD 的年龄相关性下降最为陡峭；在男性中，30 岁以后呈稳步下降。80 岁及以上的男性 FMD 高于 50-79 岁的男性。
本研究中 FMD 的分布代表了健康人群相应的年龄和性别群体，可能是未来研究的有用参考。内皮功能障碍的高比例令人惊讶。其年龄和性别分布表明，FMD≤0%先于心血管疾病发生，并且可能是识别高危个体的有力的非侵入性生物标志物。
