Correia-Costa Ana, Correia-Costa Liane, Caldas Afonso Alberto, Schaefer Franz, Guerra António, Moura Cláudia, Mota Cláudia, Barros Henrique, Areias José Carlos, Azevedo Ana
Division of Pediatric Cardiology, Integrated Pediatric Hospital, Centro Hospitalar São João, Portugal; Department of Pediatrics, Faculty of Medicine of University of Porto, Portugal.
Department of Pediatrics, Faculty of Medicine of University of Porto, Portugal; EPIUnit - Institute of Public Health, University of Porto, Portugal; Division of Pediatric Nephrology, Integrated Pediatric Hospital, Centro Hospitalar São João, Portugal.
Int J Cardiol. 2016 Sep 1;218:37-42. doi: 10.1016/j.ijcard.2016.05.060. Epub 2016 May 14.
Pulse wave velocity (PWV) is a noninvasive technique to evaluate arterial stiffness, a dynamic property of the vessels, reflecting their structure and function. Childhood obesity is associated with several cardiovascular comorbidities and to the progression of atherosclerosis. We aimed to compare carotid-femoral PWV between normal weight and overweight/obese prepubertal children and to quantify its association with other cardiovascular risk factors.
Cross-sectional study of 315 children aged 8-9years. Anthropometrics, 24-h ambulatory blood pressure (BP) and carotid-femoral PWV were measured. Classification of obesity was according to World Health Organization (WHO) body mass index (BMI)-for-age reference values.
Compared to normal weight children, overweight and obese children presented significantly higher levels of PWV (4.95 (P25-P75: 4.61-5.23), 5.00 (4.71-5.33), 5.10 (4.82-5.50) m/s, respectively; ptrend<0.001). Significant positive correlations were found between PWV and total cholesterol, LDL cholesterol, triglycerides, fasting insulin and insulin resistance levels (HOMA-IR) and with high-sensitivity C-reactive protein (hs-CRP). In a multivariate linear regression model adjusted for sex, age, height and 24-h systolic blood pressure z-score, the independent determinants of PWV were BMI, HOMA-IR and the absence of dipping.
The association between PWV and the loss of dipping and insulin resistance levels, independently of the BMI, reinforces the contribution of these comorbidities to vascular injury in early life.
脉搏波速度（PWV）是一种评估动脉僵硬度的无创技术，动脉僵硬度是血管的一种动态特性，反映了血管的结构和功能。儿童肥胖与多种心血管合并症以及动脉粥样硬化的进展相关。我们旨在比较正常体重和超重/肥胖青春期前儿童的颈动脉-股动脉PWV，并量化其与其他心血管危险因素的关联。
对315名8-9岁儿童进行横断面研究。测量人体测量学指标、24小时动态血压（BP）和颈动脉-股动脉PWV。肥胖分类依据世界卫生组织（WHO）年龄别体重指数（BMI）参考值。
与正常体重儿童相比，超重和肥胖儿童的PWV水平显著更高（分别为4.95（第25-75百分位数：4.61-5.23）、5.00（4.71-5.33）、5.10（4.82-5.50）m/s；ptrend<0.001）。PWV与总胆固醇、低密度脂蛋白胆固醇、甘油三酯、空腹胰岛素和胰岛素抵抗水平（HOMA-IR）以及高敏C反应蛋白（hs-CRP）之间存在显著正相关。在调整了性别、年龄、身高和24小时收缩压z评分的多变量线性回归模型中，PWV的独立决定因素是BMI、HOMA-IR和非勺型血压。
PWV与勺型血压消失和胰岛素抵抗水平之间的关联独立于BMI，这强化了这些合并症对早期血管损伤的影响。
