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肥胖青少年的动脉顺应性及其动态变化

Arterial compliance and its dynamics in obese adolescents.

作者信息

Svec D, Czippelova B, Mazgutova N, Matuskova L, Kuricova M, Tuzakova J, Cernochova D, Javorka M

机构信息

Department of Physiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia.

Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia.

出版信息

J Physiol Pharmacol. 2022 Oct;73(5). doi: 10.26402/jpp.2022.5.06. Epub 2023 Mar 16.

Abstract

Arterial compliance (AC) decrease with aging is accelerated by factors associated with the progression of atherosclerotic process, including obesity. Prevalence of obesity increases not only in adult population but also in children and adolescents. The results of studies characterizing the effect of obesity on AC (often indirectly estimated by pulse wave velocity (PWV)) are contradictory. Considering the limitations of previously applied methods and the need to interpret AC values in the context of potential confounders or during various physiological states, the aim of this study was to compare AC of control and obese adolescents during four different physiological states: supine rest, head-up tilt (HUT), supine recovery and mental arithmetic (MA). AC was assessed by the method based on two-element Windkessel model as the ratio of a time constant t characterizing diastolic blood pressure decay and total peripheral resistance (TPR). In total, fifty healthy and normotensive subjects (40 females, 10 males, age 17.5 years (SD=1.1 years)) were examined - 25 obese and 25 age- and sex-matched control subjects. We observed significantly increased AC values during all phases in obese group. An increase in AC was also preserved after controlling for blood pressure influence. These results were confirmed using PWV based AC estimation. Interestingly, AC decreased similarly during stress phases (HUT, MA) in both groups. Lastly, TPR was decreased throughout the study protocol in obese subjects. In conclusion, AC is increased in young obese subjects consistently during various physiological states. Furthermore, changes of physiological states evoke similar response of AC in both groups indicating preserved autonomic control of elastic arteries. A decreased TPR in obese subjects points towards the influence of different maturation state of the arterial tree and/or changes in vasomotion possibly counterbalancing acceleration of atherosclerosis process.

摘要

随着年龄增长,动脉顺应性(AC)的降低会因与动脉粥样硬化进程相关的因素(包括肥胖)而加速。肥胖的患病率不仅在成年人群中增加,在儿童和青少年中也有所上升。关于肥胖对AC影响(通常通过脉搏波速度(PWV)间接估计)的研究结果相互矛盾。考虑到先前应用方法的局限性以及在潜在混杂因素背景下或不同生理状态期间解释AC值的必要性,本研究的目的是比较对照组和肥胖青少年在四种不同生理状态下的AC:仰卧休息、头高位倾斜(HUT)、仰卧恢复和心算(MA)。AC通过基于二元Windkessel模型的方法进行评估,该方法以表征舒张压衰减的时间常数t与总外周阻力(TPR)的比值来衡量。总共检查了50名健康且血压正常的受试者(40名女性,10名男性,年龄17.5岁(标准差 = 1.1岁))——25名肥胖受试者和25名年龄及性别匹配的对照受试者。我们观察到肥胖组在所有阶段的AC值均显著增加。在控制血压影响后,AC的增加仍然存在。使用基于PWV的AC估计方法也证实了这些结果。有趣的是,两组在应激阶段(HUT、MA)AC的降低情况相似。最后,在整个研究过程中,肥胖受试者的TPR降低。总之,年轻肥胖受试者在各种生理状态下AC持续增加。此外,生理状态的变化在两组中引起了相似的AC反应,表明弹性动脉的自主控制得以保留。肥胖受试者TPR的降低表明动脉树不同成熟状态的影响和/或血管运动的变化可能抵消了动脉粥样硬化进程的加速。

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