Department of Cardiology, S. Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy.
J Adolesc Health. 2012 Oct;51(4):373-9. doi: 10.1016/j.jadohealth.2012.01.009. Epub 2012 Mar 13.
Low birth weight and accelerated postnatal growth appear to play a significant role in the pathogenesis of hypertension and cardiovascular disease in adulthood. The aim of the present study was to characterize the factors determining pulse wave velocity (PWV) in teenagers and, in particular, to verify the relationship with birth weight, postnatal growth, timing of adiposity rebound, lifestyle, and hemodynamic parameters.
Carotid-femoral and carotid-radial pulse wave velocities of 558 healthy teenagers (age range: 16.2-19.9 years) were determined by means of a PulsePen tonometer. Birth weight and gestational age were obtained from obstetrical records, and data regarding postnatal growth were obtained from pediatric clinical records.
No change in aortic PWV was found in association with birth weight, postnatal growth, and timing of adiposity rebound. However, the study showed a strong association between accelerated growth from 0 to 12 months and carotid-radial PWV (trend: p = .02). Subjects with birth weight values <2,500 g showed higher values of upper limb PWV (p < .05) and higher values of diastolic and mean arterial pressure (p < .05). Stepwise regression analysis revealed that mean arterial pressure, age, and height were the main independent factors determining aortic PWV in this young population.
These results suggest that there is no linear correlation between birth weight and hemodynamic parameters in teenagers; however, subjects characterized by very low birth weight and accelerated postnatal weight gain appear to demonstrate increased upper limb PWV and diastolic and mean arterial pressure values.
低出生体重和加速的出生后生长似乎在成年期高血压和心血管疾病的发病机制中起重要作用。本研究的目的是描述决定青少年脉搏波速度(PWV)的因素,特别是验证与出生体重、出生后生长、肥胖反弹时间、生活方式和血液动力学参数的关系。
使用 PulsePen 动脉硬度计测定 558 名健康青少年(年龄范围:16.2-19.9 岁)的颈股和颈桡脉搏波速度。出生体重和胎龄从产科记录中获得,出生后生长的数据从儿科临床记录中获得。
与出生体重、出生后生长和肥胖反弹时间相比,主动脉 PWV 没有变化。然而,研究表明,从 0 到 12 个月加速生长与颈桡 PWV 之间存在很强的相关性(趋势:p =.02)。出生体重值<2500g 的受试者上肢 PWV 较高(p <.05),舒张压和平均动脉压较高(p <.05)。逐步回归分析显示,平均动脉压、年龄和身高是该年轻人群中决定主动脉 PWV 的主要独立因素。
这些结果表明,在青少年中,出生体重与血液动力学参数之间没有线性相关性;然而,出生体重极低且出生后体重增长加速的受试者上肢 PWV 及舒张压和平均动脉压值较高。