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预测青少年心血管代谢风险的新指标及其与血管内皮功能障碍的关系:HELENA 研究。

New indices in predicting cardiometabolic risk and its relation to endothelial dysfunction in adolescents: The HELENA study.

机构信息

Postgraduate Programme in Nutrition and Health, State University of Ceará, Fortaleza, Brazil; Postgraduate Program in Collective Health State University of Ceara, Fortaleza, Brazil.

Postgraduate Programme in Nutrition and Health, State University of Ceará, Fortaleza, Brazil.

出版信息

Nutr Metab Cardiovasc Dis. 2023 May;33(5):1037-1048. doi: 10.1016/j.numecd.2023.01.015. Epub 2023 Jan 22.

Abstract

BACKGROUND AND AIMS

Blood pressure (BP) changes and insulin resistance (IR) are important cardiometabolic risk (CMR) factors; their early identification can contribute to the reduction of cardiovascular events in adulthood. This necessitates the search for more accessible and easily applied indicators for their prediction. Therefore, this study aimed to evaluate the predictive power of the indices, TyG, TG/HDL-c, height-corrected lipid accumulation product (HLAP), and visceral adiposity index (VAI), in identifying the CMR obtained by high BP and IR and to verify their relationship with biomarkers of endothelial dysfunction (ED) in European adolescents.

METHODS AND RESULTS

The anthropometric data and blood biomarkers of 744 adolescents (343 boys and 401 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS), with a mean age of 14.67 (SD 1.15) years, were assessed. The adolescents were then classified according to the presence or absence of high BP and IR. The cut-off points of the indices evaluated for the identification of CMR were determined. The relationship between CMR diagnosed using these indices and ED biomarkers was tested. The HLAP and TG/HDL-c were fair predictors of CMR obtained by IR in male adolescents. These indices showed association with hsCRP in sVCAM-1 in boys, but it lost significance after adjusting for age and body mass index.

CONCLUSION

TG/HDL-c and HLAP indices showed a fair performance in predicting CMR, obtained by IR, in male adolescents. ED showed no association with the CMR identified by the indices.

摘要

背景与目的

血压(BP)变化和胰岛素抵抗(IR)是重要的心血管代谢风险(CMR)因素;早期识别它们有助于减少成年期的心血管事件。这就需要寻找更易获得和易于应用的指标来预测它们。因此,本研究旨在评估 TyG、TG/HDL-c、校正身高的脂质蓄积产物(HLAP)和内脏脂肪指数(VAI)等指数在识别由高 BP 和 IR 引起的 CMR 方面的预测能力,并验证它们与欧洲青少年内皮功能障碍(ED)生物标志物的关系。

方法和结果

评估了来自欧洲青少年健康生活方式营养横断面研究(HELENA-CSS)的 744 名青少年(343 名男孩和 401 名女孩)的人体测量数据和血液生物标志物,平均年龄为 14.67(SD 1.15)岁。然后根据是否存在高 BP 和 IR 对青少年进行分类。确定了评估指数识别 CMR 的切点。测试了使用这些指数诊断的 CMR 与 ED 生物标志物之间的关系。HLAP 和 TG/HDL-c 是男性青少年 IR 引起的 CMR 的良好预测指标。这些指数与男孩的 hsCRP 与 sVCAM-1 之间呈正相关,但在调整年龄和体重指数后,其相关性失去了统计学意义。

结论

TG/HDL-c 和 HLAP 指数在预测男性青少年 IR 引起的 CMR 方面表现出良好的性能。ED 与指数识别的 CMR 之间没有关联。

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