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健康日本青少年的臂踝脉搏波速度:评估动脉僵硬度和心血管风险概况的参考值。

Brachial-ankle pulse wave velocity in healthy Japanese adolescents: reference values for the assessment of arterial stiffness and cardiovascular risk profiles.

机构信息

School of Health and Nursing Science, Wakayama Medical University, Wakayama, Japan.

Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan.

出版信息

Hypertens Res. 2020 Apr;43(4):331-341. doi: 10.1038/s41440-019-0370-z. Epub 2019 Dec 18.

Abstract

Brachial-ankle pulse wave velocity (baPWV) has been used as a simple and convenient method of evaluating arterial stiffness and is considered useful for screening subclinical vascular damage in primary care settings and in large populations. The aim of this study was to determine the reference values of baPWV in adolescents based on age and sex to evaluate and classify vascular abnormalities in this age population. Noninvasive baPWV measurements using an oscillometric device were carried out in 5936 participants aged 12-18 years who had no history of syndromic obesity, hypertension, dyslipidemia, diabetes mellitus, or renal disease. Of these, we extracted data from 4524 healthy adolescents free from atherosclerotic risk factors and constructed sex-specific reference percentiles normalized to age using the LMS method. The baPWV increased with age and was significantly higher in males than in females. Multivariate regression analysis demonstrated that age, body mass index, and blood pressure were the major determinants of baPWV for both males and females. Among a sample of 3825 adolescents, including individuals with risk factors, the prevalence of central obesity, raised blood pressure, raised triglycerides, reduced high-density lipoprotein cholesterol, and impaired fasting glycemia significantly increased along with the standardized baPWV z-score level. In addition, there was a graded nature regarding the association between the baPWV z-score and the clustering number of the metabolic syndrome components. These results suggest that the proposed reference values of baPWV could help classify vascular abnormalities of adolescents caused by the presence of risk factors and thereby contribute to determining individuals with cardiovascular risk in this age population.

摘要

肱踝脉搏波速度(baPWV)已被用作评估动脉僵硬度的简单方便的方法,被认为有助于在初级保健环境和大人群中筛查亚临床血管损伤。本研究旨在根据年龄和性别确定青少年 baPWV 的参考值,以评估和分类该年龄人群的血管异常。使用振荡测量设备对 5936 名年龄在 12-18 岁、无综合征性肥胖、高血压、血脂异常、糖尿病或肾脏疾病病史的参与者进行了非侵入性 baPWV 测量。在这些参与者中,我们从 4524 名无动脉粥样硬化危险因素的健康青少年中提取数据,并使用 LMS 方法将年龄标准化的性别特异性参考百分位数构建为正态分布。baPWV 随年龄增长而增加,男性明显高于女性。多元回归分析表明,年龄、体重指数和血压是男性和女性 baPWV 的主要决定因素。在包括有危险因素的 3825 名青少年样本中,随着标准化 baPWV z 分数水平的升高,中心性肥胖、血压升高、甘油三酯升高、高密度脂蛋白胆固醇降低和空腹血糖受损的患病率显著增加。此外,baPWV z 分数与代谢综合征成分聚类数之间存在分级关系。这些结果表明,所提出的 baPWV 参考值可有助于对有危险因素的青少年血管异常进行分类,从而有助于确定该年龄人群中的心血管风险个体。

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