Philip Ranjit, Alpert Bruce S, Schwingshackl Andreas, Huang Xin, Blakely Douglas, Rovnaghi Cynthia R, Tran Quynh T, Velasquez Andres', Arevalo Alejandro, Anand Kanwaljeet J S
Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN.
Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN.
J Pediatr. 2015 Aug;167(2):361-365.e1. doi: 10.1016/j.jpeds.2015.04.042. Epub 2015 May 21.
To establish reference scores for cardio-ankle vascular index (CAVI), a noninvasive measure of vascular function, which reflects the stiffness of arteries, in healthy children, to test for racial and ethnic differences, and to compare CAVI scores between overweight and normal weight children.
Subjects included 292 children aged 10-18 years: 100 non-Hispanic whites, 89 non-Hispanic blacks, and 103 Hispanics. Subjects were grouped as normal weight (body mass index [BMI] <85th percentile for age) and overweight (BMI >85th percentile for age). Blood pressure (BP) and CAVI scores were measured in all subjects.
After controlling for age, sex, and BMI, normal weight black males had a higher CAVI score (indicating stiffer arteries) in comparison with Hispanic males and white males (5.53 ± 0.15 vs 5.13 ± 0.15 vs 5.02 ± 0.15, P = .04). BMI had an inverse association on the CAVI score (r = -0.335, P < .0001). In multivariable analysis, BMI and average CAVI scores were significant predictors of each other (R(2) = 0.37, P < .0001, R(2) = 0.21, P < .0001). There was no significant correlation between CAVI scores and resting BP values, confirming that CAVI scores were independent of concurrent BP values.
Significant differences in vascular function exist among ethnic groups of children. Overweight children had lower CAVI scores, suggestive of vascular adaptation to obesity in early life. CAVI, by providing a noninvasive measure of vascular health, may help identify children at increased risk for cardiovascular disease.
建立健康儿童心脏-踝部血管指数(CAVI)的参考评分,CAVI是一种反映动脉僵硬度的血管功能无创测量指标,检测种族和民族差异,并比较超重与正常体重儿童的CAVI评分。
研究对象包括292名10 - 18岁儿童:100名非西班牙裔白人、89名非西班牙裔黑人以及103名西班牙裔。研究对象按正常体重(体重指数[BMI]<年龄别第85百分位数)和超重(BMI>年龄别第85百分位数)分组。测量所有研究对象的血压(BP)和CAVI评分。
在控制年龄、性别和BMI后,正常体重的黑人男性与西班牙裔男性和白人男性相比,CAVI评分更高(表明动脉更僵硬)(5.53±0.15 vs 5.13±0.15 vs 5.02±0.15,P = 0.04)。BMI与CAVI评分呈负相关(r = -0.335,P < 0.0001)。在多变量分析中,BMI和平均CAVI评分是彼此的显著预测因素(R² = 0.37,P < 0.0001,R² = 0.21,P < 0.0001)。CAVI评分与静息血压值之间无显著相关性,证实CAVI评分独立于同时测量的血压值。
儿童不同种族群体的血管功能存在显著差异。超重儿童的CAVI评分较低,提示早年血管对肥胖的适应性。CAVI通过提供血管健康的无创测量指标,可能有助于识别心血管疾病风险增加的儿童。