Division of Cardiovascular Prevention, Rehabilitation, and Sports Cardiology, Department of Cardiology, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
J Pediatr. 2012 Nov;161(5):887-91. doi: 10.1016/j.jpeds.2012.04.033. Epub 2012 May 23.
To determine the role of pubertal status on microvascular function in healthy children and adolescents.
Children and adolescents (n = 112; age 10-16 years) were investigated in 2 separate prospective cross-sectional studies. The main outcome measure was microvascular function, assessed by peripheral arterial tonometry to determine the reactive hyperemic index (RHI). Physical activity was assessed using 7-day recall in one study and accelerometry in the other study. Subjects were grouped based on their self-assessed pubertal status according to Tanner stage: group 1 (prepuberty, Tanner I), group 2 (mid-puberty, Tanner II/III), and group 3 (late puberty, Tanner IV/V). Stepwise multiple regression analysis was performed to identify independent predictors of the RHI.
Complete data were available for 94 subjects (55 females) with a median (IQR) age of 14 (3.0) years and a mean body mass index of 19.0 ± 3.63 kg·m(-2). Significant correlations with RHI were observed for Tanner stage (r = 0.569; P < .001), age (r = 0.567; P < .001), stature (r = 0.553; P < .001), systolic blood pressure (r = 0.494; P < .001), and body mass index (r = 0.309; P = .001), but not for sex and moderate-to-vigorous physical activity. In stepwise regression analysis, pubertal status was the only independent predictor of microvascular function (R(2) = 0.242; β = 0.492; P < .001). Prepubertal children (group 1) had a significantly lower RHI [1.14 (0.24)] compared with group 2 [1.65 (0.57)] and group 3 [1.70 (0.75)] (all P < .001).
Pubertal status was the main predictor of microvascular function in healthy children and adolescents. Future studies investigating microvascular function in this age group should assess and control for pubertal maturation.
确定青春期状态对健康儿童和青少年微血管功能的影响。
在两项独立的前瞻性横断面研究中对儿童和青少年（n=112；年龄 10-16 岁）进行了调查。主要观察指标是通过外周动脉张力测定来评估微血管功能，以确定反应性充血指数（RHI）。一项研究中使用 7 天回顾法评估体力活动，另一项研究中使用加速度计评估体力活动。根据 Tanner 分期，根据自我评估的青春期状态将受试者分为三组：第 1 组（青春期前，Tanner I 期）、第 2 组（青春期中期，Tanner II/III 期）和第 3 组（青春期后期，Tanner IV/V 期）。采用逐步多元回归分析来确定 RHI 的独立预测因素。
共有 94 名（55 名女性）受试者完成了完整的数据采集，中位（IQR）年龄为 14（3.0）岁，平均体重指数为 19.0±3.63kg·m(-2)。RHI 与 Tanner 分期（r=0.569；P<0.001）、年龄（r=0.567；P<0.001）、身高（r=0.553；P<0.001）、收缩压（r=0.494；P<0.001）和体重指数（r=0.309；P=0.001）呈显著相关，但与性别和中高强度体力活动无关。在逐步回归分析中，青春期状态是微血管功能的唯一独立预测因素（R(2)=0.242；β=0.492；P<0.001）。青春期前儿童（第 1 组）的 RHI[1.14（0.24）]明显低于第 2 组[1.65（0.57）]和第 3 组[1.70（0.75）]（均 P<0.001）。
青春期状态是健康儿童和青少年微血管功能的主要预测因素。未来在该年龄组中研究微血管功能时，应评估和控制青春期成熟度。
