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青少年肥胖与血管老化的关联——一项使用超高分辨率超声的研究

Obesity in adolescents associated with vascular aging - a study using ultra-high-resolution ultrasound.

作者信息

Naessen Tord, Bergsten Peter, Lundmark Tobias, Forslund Anders

机构信息

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.

出版信息

Ups J Med Sci. 2022 Jun 3;127. doi: 10.48101/ujms.v127.8676. eCollection 2022.

Abstract

BACKGROUND

Obesity in adolescents is increasing worldwide and associated with an elevated cardiovascular risk later in life. In a group-comparative study, we investigated the association between adiposity in adolescents and signs of vascular aging and inflammation.

METHODS

Thirty-nine adolescents (10-18 years old), 19 with obesity and 20 with normal weight, were enrolled. The intima thickness and intima/media thickness ratio (I/M) were assessed using high-resolution ultrasound in the common carotid artery (center frequency 22 MHz) and the distal radial artery (RA; 50 MHz). Increased intima and high I/M are signs of vascular aging. Body characteristics, high-sensitivity C-reactive protein (hs-CRP), plasma lipids, and glycemic parameters were measured.

RESULTS

Adolescents with obesity, compared to normal-weight peers, had elevated plasma lipid, insulin c-peptide, and hs-CRP levels, the latter increasing exponentially with increasing adiposity. Obese adolescents had a thicker RA intima layer [0.005 mm; 95% confidence intervals (0.000, 0.009); = 0.043] and a higher RA I/M [0.10; (0.040, 0.147); 0.0007]. Group differences for the RA I/M remained significant after adjustment for age, sex, fasting plasma insulin, and body mass index, both separately and together ( 0.032). The RA I/M was correlated with hs-CRP, and both were correlated with the analyzed cardiovascular risk factors. Receiver operating curve c-values for RA I/M (0.86) and hs-CRP (0.90) strongly indicated correct placement in the obese or non-obese group.

CONCLUSIONS

Adolescents with obesity had significantly more extensive vascular aging in the muscular RA, than normal-weight peers. The findings support an inflammatory link between obesity and vascular aging in adolescents.

摘要

背景

青少年肥胖在全球范围内呈上升趋势,且与日后心血管疾病风险升高相关。在一项组间比较研究中,我们调查了青少年肥胖与血管老化及炎症迹象之间的关联。

方法

招募了39名青少年(10 - 18岁),其中19名肥胖青少年和20名体重正常青少年。使用高分辨率超声评估颈总动脉(中心频率22兆赫兹)和桡动脉远端(RA;50兆赫兹)的内膜厚度和内膜/中膜厚度比(I/M)。内膜增厚和高I/M是血管老化的迹象。测量身体特征、高敏C反应蛋白(hs-CRP)、血脂和血糖参数。

结果

与体重正常的同龄人相比,肥胖青少年的血脂、胰岛素C肽和hs-CRP水平升高,后者随肥胖程度增加呈指数增长。肥胖青少年的RA内膜层更厚[0.005毫米;95%置信区间(0.000,0.009);P = 0.043],RA的I/M更高[0.10;(0.040,0.147);P = 0.0007]。在分别或综合调整年龄、性别、空腹血浆胰岛素和体重指数后,RA的I/M组间差异仍显著(P = 0.032)。RA的I/M与hs-CRP相关,且两者均与分析的心血管危险因素相关。RA的I/M(0.86)和hs-CRP(0.90)的受试者工作特征曲线c值强烈表明在肥胖或非肥胖组中的正确分类。

结论

肥胖青少年的肌肉型RA血管老化程度明显高于体重正常的同龄人。这些发现支持了青少年肥胖与血管老化之间的炎症联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/093a/9254329/541d4f0211ce/UJMS-127-8676-g001.jpg

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