一项关于儿童和青少年血管健康非侵入性标志物的横断面研究。
A cross-sectional study of non-invasive markers of vascular health in children and adolescents.
作者信息
Nasir Reeja F, Cai Tommy Y, Meroni Alice, Dissanayake Hasthi, Gordon Adrienne, Celermajer David S, Skilton Michael R
机构信息
The Boden Initiative, Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.
Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
出版信息
Pediatr Res. 2025 May 3. doi: 10.1038/s41390-025-04041-w.
BACKGROUND
Non-invasive methods assessing subclinical atherosclerosis, such as carotid intima-media thickness (IMT) and carotid-femoral pulse wave velocity (cfPWV), are well-described in adults but less so in the paediatric population. Other techniques, such as aortic IMT, may be more appropriate in children. This study aimed to characterise age-related changes to arterial vasculature using best practice methodology for these measures.
METHODS
This cross-sectional study involved 97 healthy volunteers aged 2 to 20 (mean age 11.2 years [SD 5.1]). Carotid and aortic IMT were measured using high-resolution ultrasound. A validated semi-automated cuff-based device was used to measure cfPWV.
RESULTS
Aortic IMT showed a significant age-related increase of 9 μm per year [95% CI: 6, 12], p < 0.0001) during childhood and adolescence, whilst carotid IMT was significantly associated with male sex (29 μm per year [95% CI: 11, 48], p = 0.002) during this period. cfPWV exhibited an age-related increase from nine years of age onwards (0.11 ms per year [95% CI: 0.06, 0.15], p < 0.001).
CONCLUSIONS
Age-related changes in the arterial vasculature vary between sites and methodologies. During childhood, aortic IMT appears to be a more sensitive marker for early structural changes and should be prioritised over carotid IMT and cfPWV.
IMPACT
Understanding age-related changes in arterial vasculature via non-invasive measures is poorly described in childhood and adolescence. This study finds that the timing and magnitude of age-related changes vary across arterial beds and between non-invasive measures in the first two decades of life. Aortic intima-media thickness is a more age-appropriate measure of early structural changes in the young than the more widely used carotid intima-media thickness. Furthermore, carotid-femoral pulse wave velocity, a measure of aortic stiffness, is best evaluated in late childhood and adolescence and likely has little relevance in early childhood.
背景
评估亚临床动脉粥样硬化的非侵入性方法，如颈动脉内膜中层厚度（IMT）和颈股脉搏波速度（cfPWV），在成年人中已有详尽描述，但在儿科人群中描述较少。其他技术，如主动脉IMT，可能对儿童更为适用。本研究旨在使用这些测量的最佳实践方法来描述动脉血管系统与年龄相关的变化。
方法
这项横断面研究纳入了97名年龄在2至20岁（平均年龄11.2岁[标准差5.1]）的健康志愿者。使用高分辨率超声测量颈动脉和主动脉IMT。使用经过验证的基于袖带的半自动设备测量cfPWV。
结果
在儿童期和青少年期，主动脉IMT显示出与年龄显著相关的每年增加9μm[95%置信区间：6，12]，p<0.0001），而在此期间颈动脉IMT与男性显著相关（每年29μm[95%置信区间：11，48]，p=0.002）。cfPWV从9岁起呈现出与年龄相关的增加（每年0.11m/s[95%置信区间：0.06，0.15]，p<0.001）。
结论
动脉血管系统与年龄相关的变化因部位和方法而异。在儿童期，主动脉IMT似乎是早期结构变化的更敏感标志物，应优先于颈动脉IMT和cfPWV。
影响
通过非侵入性测量了解动脉血管系统与年龄相关的变化在儿童期和青少年期描述较少。本研究发现，在生命最初的二十年中，与年龄相关变化的时间和幅度在不同动脉床之间以及非侵入性测量之间有所不同。与更广泛使用的颈动脉内膜中层厚度相比，主动脉内膜中层厚度是更适合评估年轻人早期结构变化的指标。此外，颈股脉搏波速度作为主动脉僵硬度的一种测量方法，在儿童晚期和青少年期评估最佳，在幼儿期可能相关性不大。
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