Garcia-Espinosa Victoria, Bia Daniel, Castro Juan, Zinoveev Agustina, Marin Mariana, Giachetto Gustavo, Chiesa Pedro, Zócalo Yanina
Physiology Department, Faculty of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.
Pediatric Clinic, Faculty of Medicine, Pereira-Rossell Hospital, Republic University, Bulevar Artigas 1550, 11600, Montevideo, Uruguay.
High Blood Press Cardiovasc Prev. 2018 Sep;25(3):267-280. doi: 10.1007/s40292-018-0264-1. Epub 2018 Jul 2.
The aim was to analyze and compare the associations between body mass index (BMI) and structural and functional cardiovascular variables measured in children and adolescents.
609 healthy subjects (mean age/range 12/4-18 years, 45% females) were studied. Subjects' BMI and the corresponding z-scores (z-BMI) were determined. Cardiovascular measurements: peripheral and aortic blood pressure (BP), aortic wave-derived parameters, common carotid, femoral and brachial artery diameters and stiffness, carotid intima-media thickness, carotid-radial and carotid-femoral pulse wave velocity (crPWV, cfPWV) and cfPWV/crPWV ratio. Cardiovascular data were standardized (z-scores) using equations (fractional polynomials) obtained from a sub-group (reference population, n = 241) non-exposed to cardiovascular risk factors (CVRFs). Simple and multiple regression models were obtained for the associations between cardiovascular z-scores and z-BMI and/or z-BMI, age, sex and CVRFs.
z-BMI was associated with standardized cardiovascular variables, regardless of age, sex and CVRFs. BP (peripheral rather than aortic) was the variable with the greatest variations associated with z-BMI. Systolic (SBP) and pulse pressure (PP; in that order) were the variables with the highest variations associated with z-BMI. Carotid, but not femoral or brachial stiffness showed BP-dependent variations associated with z-BMI. Arterial diameters were associated with z-BMI, without differences among arteries.
In children and adolescents, z-BMI was gradually and positively associated with haemodynamic (peripheral and central BP) and vascular parameters (structural and functional) with independence of age, sex and other CVRFs (Dyslipidemia, Hypertension, Smoke, Diabetes). There were differences in the associations depending on the arteries studied and on whether central or peripheral haemodynamic parameters were analyzed.
分析并比较儿童和青少年的体重指数（BMI）与所测量的心血管结构和功能变量之间的关联。
对609名健康受试者（平均年龄/范围12/4 - 18岁，45%为女性）进行了研究。测定了受试者的BMI及相应的z评分（z - BMI）。心血管测量指标包括：外周和主动脉血压（BP）、主动脉波形衍生参数、颈总动脉、股动脉和肱动脉直径及僵硬度、颈动脉内膜中层厚度、颈 - 桡和颈 - 股脉搏波速度（crPWV、cfPWV）以及cfPWV/crPWV比值。心血管数据使用从一个未暴露于心血管危险因素（CVRF）的亚组（参考人群，n = 241）获得的方程（分数多项式）进行标准化（z评分）。获得了心血管z评分与z - BMI和/或z - BMI、年龄、性别及CVRF之间关联的简单和多元回归模型。
无论年龄、性别和CVRF如何，z - BMI均与标准化心血管变量相关。血压（外周血压而非主动脉血压）是与z - BMI相关变化最大的变量。收缩压（SBP）和脉压（PP；按此顺序）是与z - BMI相关变化最高的变量。颈动脉僵硬度（而非股动脉或肱动脉僵硬度）显示出与z - BMI相关的血压依赖性变化。动脉直径与z - BMI相关，各动脉之间无差异。
在儿童和青少年中，z - BMI与血流动力学（外周和中心血压）及血管参数（结构和功能）呈逐渐增强的正相关，且独立于年龄、性别和其他CVRF（血脂异常、高血压、吸烟、糖尿病）。根据所研究的动脉以及分析的是中心还是外周血流动力学参数，关联存在差异。
