Section of Pediatric Cardiology Department of Pediatrics Texas Children's HospitalBaylor College of Medicine Houston TX.
Department of Cardiology Boston Children's HospitalHarvard Medical School Boston MA.
J Am Heart Assoc. 2021 Mar 16;10(6):e018419. doi: 10.1161/JAHA.120.018419. Epub 2021 Mar 1.
Background Aortic stiffening begins in youth and antedates future hypertension. In adults, excess weight, systemic inflammation, dyslipidemia, insulin resistance, neurohormonal activation, and altered adipokines are implicated in the pathogenesis of increased aortic stiffness. In adolescents, we assessed the relations of comprehensive measures of aortic stiffness with body mass index (BMI) and related but distinct circulating biomarkers. Methods and Results A convenience sample of 246 adolescents (mean age, 16±2 years; 45% female, 24% Black, and 43% Hispanic) attending primary care or preventive cardiology clinics at 2 tertiary hospitals was grouped as normal weight (N=98) or excess weight (N=148, defined as BMI ≥age- and sex-referenced 85th percentile). After an overnight fast, participants underwent anthropometry, noninvasive arterial tonometry, and assays for serum lipids, CRP (C-reactive protein), glucose, insulin, renin, aldosterone, and leptin. We used multivariable linear regression to relate arterial stiffness markers (including carotid-femoral pulse wave velocity) to BMI score and a biomarker panel. Carotid-femoral pulse wave velocity was higher in excess weight compared with normal weight group (5.0±0.7 versus 4.6±0.6 m/s; <0.01). After multivariable adjustment, carotid-femoral pulse wave velocity was associated with BMI score (0.09 [95% CI, 0.01-0.18]; =0.04) and with low-density lipoprotein cholesterol (0.26 [95% CI, 0.03-0.50]; =0.03). Conclusions Higher BMI and low-density lipoprotein cholesterol were associated with greater aortic stiffness in adolescents. Maintaining optimal BMI and lipid levels may mitigate aortic stiffness.
背景 主动脉僵硬度在青年时期就开始增加，并先于未来的高血压。在成年人中，超重、全身炎症、血脂异常、胰岛素抵抗、神经激素激活和脂肪因子改变与主动脉僵硬度的增加有关。在青少年中，我们评估了综合主动脉僵硬度测量与体重指数（BMI）的关系，以及与 BMI 相关但不同的循环生物标志物。
方法和结果 我们选择了 2 家三级医院的初级保健或预防心脏病学诊所的 246 名青少年（平均年龄 16±2 岁；45%为女性，24%为黑人，43%为西班牙裔）作为便利样本，分为正常体重组（N=98）或超重组（N=148，定义为 BMI≥年龄和性别参考 85 百分位）。参与者在过夜禁食后接受了人体测量、无创动脉张力测量以及血清脂质、C 反应蛋白（CRP）、葡萄糖、胰岛素、肾素、醛固酮和瘦素的检测。我们使用多元线性回归来分析动脉僵硬度标志物（包括颈股脉搏波速度）与 BMI 评分和生物标志物谱的关系。与正常体重组相比，超重组的颈股脉搏波速度更高（5.0±0.7 与 4.6±0.6 m/s；<0.01）。经过多变量调整后，颈股脉搏波速度与 BMI 评分（0.09[95%CI，0.01-0.18]；=0.04）和低密度脂蛋白胆固醇（0.26[95%CI，0.03-0.50]；=0.03）相关。
结论 较高的 BMI 和低密度脂蛋白胆固醇与青少年的主动脉僵硬度增加有关。保持理想的 BMI 和血脂水平可能会减轻主动脉僵硬度。
