Department of Pediatrics and Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana.
Metab Syndr Relat Disord. 2020 Feb;18(1):10-30. doi: 10.1089/met.2019.0073. Epub 2019 Oct 16.
Cardiovascular disease (CVD) is the leading cause of fatality and disability worldwide regardless of gender. Obesity has reached epidemic proportions in population across different regions. According to epidemiological studies, CVD risk markers in childhood obesity are one of the significant risk factors for adulthood CVD, but have received disproportionally little attention. This review has examined the evidence for the presence of traditional cardiac biomarkers (nonspecific; lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, creatine kinase, myoglobulin, glycogen phosphorylase isoenzyme BB, myosin light chains, ST2, and ischemia-modified albumin) and novel emerging cardiac-specific biomarkers (cardiac troponins, natriuretic peptides, heart-type fatty acid-binding protein, and miRNAs). Besides, noninvasive anatomical and electrophysiological markers (carotid intima-media thickness, coronary artery calcification, and heart rate variability) in CVDs and obesity are also discussed. Modifiable and nonmodifiable risk factors associated with metabolic syndrome in the progression of CVD, such as obesity, diabetes, hypertension, dyslipidemia, oxidative stress, inflammation, and adipocytokines are also outlined. These underlying prognostic risk factors predict the onset of future microvascular and macrovascular complications. The understanding of invasive and noninvasive cardiac-specific biomarkers and the risk factors may yield valuable insights into the pathophysiology and prevention of CVD in a high-risk obese population at an early stage.
心血管疾病(CVD)是全球范围内导致死亡和残疾的主要原因,与性别无关。肥胖已在不同地区的人群中达到流行程度。根据流行病学研究,儿童肥胖中的 CVD 风险标志物是成年 CVD 的重要危险因素之一,但受到的关注不成比例。本综述检查了传统心脏生物标志物(非特异性;乳酸脱氢酶、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、肌酸激酶、肌球蛋白、糖原磷酸化酶同工酶 BB、肌钙蛋白、肌球蛋白轻链、ST2 和缺血修饰白蛋白)和新型新兴心脏特异性生物标志物(肌钙蛋白、利钠肽、心脏型脂肪酸结合蛋白和 miRNA)存在的证据。此外,还讨论了 CVD 和肥胖中无创解剖学和电生理学标志物(颈动脉内膜中层厚度、冠状动脉钙化和心率变异性)。还概述了与 CVD 进展相关的代谢综合征的可改变和不可改变的危险因素,如肥胖、糖尿病、高血压、血脂异常、氧化应激、炎症和脂肪细胞因子。这些潜在的预后危险因素预测了未来微血管和大血管并发症的发生。对侵入性和非侵入性心脏特异性生物标志物以及危险因素的了解可能会深入了解高危肥胖人群中 CVD 的病理生理学和预防。