Division of Endocrinology, Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
Division of Emergency Medicine, Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
Pediatr Diabetes. 2019 Nov;20(7):842-848. doi: 10.1111/pedi.12896. Epub 2019 Jul 28.
Cardiovascular disease has its origins in adolescents. Endothelial dysfunction, arterial stiffness, and decreased endocardial oxygen supply: demand ratios are early functional markers of cardiovascular risk. The goal of this study was to determine the relationships of these markers to physical, inflammatory, and metabolic markers in healthy non-Hispanic, white adolescents.
Thirty-four of the 75 subjects were female. Mean age was 15.0 ± 1.7 years and mean body mass index (BMI) was 22.0 ± 5.8 kg/m (mean ± SD). Reactive hyperemia was measured using venous occlusion plethysmography. Arterial tonometry was used to measure the augmentation index (AIx ) and the Buckberg subendocardial viability ratio. Blood samples were taken to measure inflammatory and lipid markers and oral glucose tolerance test was used to assess insulin sensitivity.
Reactive hyperemia decreased as body mass and fat mass increased. It also decreased with increasing neutrophil count. The Buckberg index was higher in males and was positively related to insulin sensitivity even when accounting for age, sex, and resting heart rate. AIx was not related to any of the other variables.
These results demonstrate that increased fat mass and decreased insulin sensitivity are related to poorer vascular function and cardiac risk in adolescents before the development of actual cardiovascular disease.
心血管疾病起源于青少年时期。内皮功能障碍、动脉僵硬和心内膜氧供与需求比例降低是心血管风险的早期功能标志物。本研究的目的是确定这些标志物与健康的非西班牙裔白种青少年的身体、炎症和代谢标志物之间的关系。
75 名受试者中有 34 名女性。平均年龄为 15.0±1.7 岁，平均体重指数（BMI）为 22.0±5.8kg/m（平均值±标准差）。使用静脉闭塞体积描记法测量反应性充血。使用动脉张力测定法测量增强指数（AIx）和 Buckberg 心内膜下存活比。采集血样以测量炎症和脂质标志物，并进行口服葡萄糖耐量试验以评估胰岛素敏感性。
反应性充血随着体重和体脂增加而减少。它也随着中性粒细胞计数的增加而减少。Buckberg 指数在男性中较高，即使在考虑年龄、性别和静息心率的情况下，它与胰岛素敏感性也呈正相关。AIx 与其他任何变量均无关。
这些结果表明，在实际心血管疾病发生之前，肥胖和胰岛素敏感性降低与青少年血管功能和心脏风险增加有关。
