从儿童期到成年早期的颈动脉和主动脉可扩张性的心脏代谢决定因素。
Cardiometabolic Determinants of Carotid and Aortic Distensibility From Childhood to Early Adulthood.
机构信息
From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Paediatrics and Adolescent Medicine (H.N.), Department of Medicine (T.R., J.S.A.V., M.J.), and Department of Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku, Finland; Department of Paediatrics and Adolescent Medicine (H.N.), Department of Clinical Physiology and Nuclear Medicine (O.T.R.), and Division of Medicine (T.R., J.S.A.V., M.J.), Turku University Hospital, Finland; and Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.)
From the Research Centre of Applied and Preventive Cardiovascular Medicine (H.M., K.P., O.T.R.), Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity (K.P.), Department of Paediatrics and Adolescent Medicine (H.N.), Department of Medicine (T.R., J.S.A.V., M.J.), and Department of Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku, Finland; Department of Paediatrics and Adolescent Medicine (H.N.), Department of Clinical Physiology and Nuclear Medicine (O.T.R.), and Division of Medicine (T.R., J.S.A.V., M.J.), Turku University Hospital, Finland; and Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland (A.J.).
出版信息
Hypertension. 2017 Aug;70(2):452-460. doi: 10.1161/HYPERTENSIONAHA.117.09027. Epub 2017 Jun 26.
UNLABELLED
Children who are obese or have familial hypercholesterolemia have stiffer arteries compared with lean, healthy peers. Limited data are, however, available on the association of cardiometabolic risk markers and arterial distensibility in healthy children, particularly in a longitudinal setting. Therefore, we studied in the prospective STRIP (Special Turku Coronary Risk Factor Intervention Project) comprising healthy, predominantly normal weight participants the association of several cardiometabolic and dietary risk markers with arterial distensibility from childhood to early adulthood. Carotid and aortic distensibility (cdist, adist) was assessed repeatedly with ultrasonography at the age of 11, 13, 15, 17, and 19 years in the longitudinal atherosclerosis prevention study (n=420-503, n=407-476). Data on cardiometabolic risk markers and diet were available since early childhood. In multivariable analyses, body mass index (β=-0.0019 [SE 0.0085]; =0.037), systolic blood pressure (β=-0.0025 [SE 0.00065]; =0.0001), low-density lipoprotein cholesterol (β=-0.026 [SE 0.012]; =0.034), and homeostasis model of insulin resistance (β=-0.048 [SE 0.018]; =0.0071) were independently associated with carotid distensibility. Systolic blood pressure (β=-0.0069 [SE 0.00097]; <0.0001) and low-density lipoprotein cholesterol (β=-0.039 [SE 0.018]; =0.031) associated independently with aortic distensibility. Dietary variables were not independently associated with arterial distensibility. Participants with low arterial distensibility had higher body mass index (=0.0090, =0.098) and higher systolic (<0.0001, <0.0001) and diastolic blood pressures (<0.0001, =0.0002) already from early childhood. Body mass index, blood pressure, low-density lipoprotein cholesterol, and homeostasis model of insulin resistance identified since childhood associate with arterial distensibility in healthy children and adolescents. These data support the relevance of these factors as part of primordial prevention.
CLINICAL TRIAL REGISTRATION
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00223600.
目的
研究在健康的儿童中，几种心血管代谢和饮食风险标志物与动脉扩张性从儿童到成年早期的关系。
方法
前瞻性 STRIP（特殊图尔库冠状动脉风险因素干预研究）包括健康的、主要是正常体重的参与者，从 11 岁、13 岁、15 岁、17 岁和 19 岁开始，通过超声检查多次评估颈动脉和主动脉扩张性（cdist、adist）。自儿童早期以来，可获得心血管代谢风险标志物和饮食的数据。
结果
多变量分析显示，体重指数（β=-0.0019 [SE 0.0085]； =0.037）、收缩压（β=-0.0025 [SE 0.00065]； =0.0001）、低密度脂蛋白胆固醇（β=-0.026 [SE 0.012]； =0.034）和胰岛素抵抗的稳态模型（β=-0.048 [SE 0.018]； =0.0071）与颈动脉扩张性独立相关。收缩压（β=-0.0069 [SE 0.00097]； <0.0001）和低密度脂蛋白胆固醇（β=-0.039 [SE 0.018]； =0.031）与主动脉扩张性独立相关。饮食变量与动脉扩张性无关。动脉扩张性低的参与者从儿童早期开始，体重指数就更高（=0.0090，=0.098），收缩压（<0.0001，<0.0001）和舒张压（<0.0001，=0.0002）也更高。从儿童时期开始，体重指数、血压、低密度脂蛋白胆固醇和胰岛素抵抗的稳态模型与健康儿童和青少年的动脉扩张性相关。这些数据支持这些因素作为原始预防的一部分的相关性。
结论
在健康的儿童中，心血管代谢和饮食风险标志物与动脉扩张性有关，这一发现强调了这些因素在心血管疾病预防中的重要性。
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