年龄对人类血管平滑肌功能的影响。
The impact of age on vascular smooth muscle function in humans.
作者信息
Montero David, Pierce Gary L, Stehouwer Coen D A, Padilla Jaume, Thijssen Dick H J
机构信息
aDepartment of Internal Medicine, Maastricht University Medical Centre (MUMC) and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands bDepartment of Health and Human Physiology, University of Iowa, Iowa City, Iowa cDepartment of Nutrition and Exercise Physiology dDepartment of Child Health eDalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri, USA fDepartment of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands gResearch Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
出版信息
J Hypertens. 2015 Mar;33(3):445-53; discussion 453. doi: 10.1097/HJH.0000000000000446.
AIM
Advanced age is associated with vascular endothelial dysfunction, characterized by reductions in the endothelium-dependent vasodilation of the conduit and resistance arteries, in part, from decreased nitric oxide bioavailability. Although vascular smooth muscle function (SMF), assessed by responsiveness to an exogenous nitric oxide donor, is typically reported to be intact, many of these studies are limited by a small sample size. Therefore, the purpose of this meta-analysis is to systematically review and determine whether vascular SMF is different between older versus young healthy individuals.
DESIGN
We conducted a systematic search of MEDLINE, Cochrane and Scopus, since their inceptions until January 2014, for articles evaluating SMF in the brachial artery and/or resistance arteries (BASMF and RASMF, respectively), as assessed by the endothelium-independent vasodilator response to exogenous nitric oxide donors in older (≥60 years) and young (<30 years) groups of healthy individuals. Meta-analyses were performed to compare the mean difference in BASMF and the standardized mean difference in RASMF between older and young groups. Subgroup analyses were performed to identify sources of heterogeneity.
RESULTS
Fifteen studies assessing BASMF and 20 studies assessing RASMF were included, comprising 550 older and 516 young healthy individuals. After data pooling, BASMF and RASMF were lower in older compared with the young groups (mean difference = -1.89%, P = 0.04; standardized mean difference = -0.46, P = 0.0008, respectively). Significant heterogeneity was observed in the BASMF (I2 = 74%, P < 0.00001) and the RASMF (I2 = 57%, P = 0.0008) meta-analyses. Subgroup analyses revealed that studies with (predominantly) men showed similar SMF responses between the older and the young groups.
CONCLUSION
On the basis of the current published studies, vascular SMF is reduced in conduit and resistance arteries of otherwise healthy older individuals, particularly in women.
目的
高龄与血管内皮功能障碍相关，其特征是传导动脉和阻力动脉的内皮依赖性血管舒张功能降低，部分原因是一氧化氮生物利用度降低。尽管通过对外源性一氧化氮供体的反应性评估的血管平滑肌功能（SMF）通常报告为正常，但这些研究大多受样本量小的限制。因此，本荟萃分析的目的是系统评价并确定健康老年个体与年轻个体之间的血管SMF是否存在差异。
设计
我们对MEDLINE、Cochrane和Scopus进行了系统检索，检索时间从其创建至2014年1月，以查找评估健康老年（≥60岁）和年轻（<30岁）个体肱动脉和/或阻力动脉（分别为BASMF和RASMF）中SMF的文章，通过对外源性一氧化氮供体的非内皮依赖性血管舒张反应进行评估。进行荟萃分析以比较老年组和年轻组之间BASMF的平均差异以及RASMF的标准化平均差异。进行亚组分析以确定异质性来源。
结果
纳入了15项评估BASMF的研究和20项评估RASMF的研究，包括550名老年健康个体和516名年轻健康个体。数据合并后，老年组的BASMF和RASMF低于年轻组（平均差异=-1.89%，P=0.04；标准化平均差异=-0.46，P=0.0008）。在BASMF（I2=74%，P<0.00001）和RASMF（I2=57%，P=0.0008）的荟萃分析中观察到显著的异质性。亚组分析显示，（主要）男性参与的研究中，老年组和年轻组的SMF反应相似。
结论
根据目前已发表的研究，在其他方面健康的老年个体的传导动脉和阻力动脉中，血管SMF降低，尤其是在女性中。
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