Lloyd Kelly D, Barinas-Mitchell Emma, Kuller Lewis H, Mackey Rachel H, Wong Eric A, Sutton-Tyrrell Kim
Department of Epidemiology and Public Health, School of Medicine, University of Maryland Baltimore, 660 W. Redwood Street, Baltimore, MD 21201, USA.
Int J Vasc Med. 2012;2012:169323. doi: 10.1155/2012/169323. Epub 2012 Aug 21.
Arterial diameter is an underutilized indicator of vascular health. We hypothesized that interadventitial and lumen diameter of the common carotid artery would be better indicators of vascular health than carotid plaque or intima media thickness (IMT). Participants were 491 overweight or obese, postmenopausal women who were former or current hormone therapy (HT) users, 52-62 years, with waist circumference >80 cm. We evaluated cross-sectional associations of cardiovascular risk factors with carotid measures, by HT status. Former HT users had a worse cardiovascular profile than current HT users: larger adventitial (6.94 mm versus 6.79 mm) and lumen diameter (5.44 mm versus 5.31 mm, both P < 0.01) independent of cardiovascular risk factors; IMT and plaque were similar. Larger diameters were best explained by former HT use, higher pulse pressure, and greater weight. Independent of potential confounders, overweight and obese postmenopausal former HT users had larger carotid diameters than current HT users. Carotid diameter should be considered in studies of HT.
动脉直径是一个未得到充分利用的血管健康指标。我们推测，颈总动脉的外膜间直径和管腔直径比颈动脉斑块或内膜中层厚度（IMT）更能准确反映血管健康状况。研究对象为491名年龄在52至62岁之间、腰围大于80厘米、曾使用或正在使用激素疗法（HT）的超重或肥胖绝经后女性。我们根据激素疗法使用情况，评估了心血管危险因素与颈动脉测量指标之间的横断面关联。与目前仍在使用激素疗法的女性相比，曾使用激素疗法的女性心血管状况更差：外膜直径更大（分别为6.94毫米和6.79毫米），管腔直径也更大（分别为5.44毫米和5.31毫米，P均<0.01），且不受心血管危险因素影响；内膜中层厚度和斑块情况相似。直径较大最能通过曾使用激素疗法、较高脉压和较大体重来解释。在排除潜在混杂因素后，超重和肥胖的绝经后曾使用激素疗法的女性的颈动脉直径大于目前仍在使用激素疗法的女性。在激素疗法研究中应考虑颈动脉直径这一因素。
