中国儿童和青少年特定年龄和性别的血流介导的血管舒张参考值及预测因素。

Age and gender-specific flow-mediated dilation reference values and predictive factors for Chinese children and adolescents.

作者信息

So Enoch C, Chan Kate C, Au Chun T, Chook Ping, Yu Magnum K, So Hung K, Chan Michael H, Woo Kam S, Celermajer David S, Li Albert Martin

机构信息

Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.

Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.

出版信息

BMC Pediatr. 2025 Aug 7;25(1):610. doi: 10.1186/s12887-025-05974-1.

DOI:10.1186/s12887-025-05974-1

PMID:40775699

Abstract

BACKGROUND

We aim to establish normative reference values of brachial artery flow-mediated dilation (FMD) by age and gender in children and adolescents, and to identify predictors of FMD in this population.

METHODS

A representative sample of 1498 healthy children and adolescents aged 8 to 17 years was recruited. Subjects underwent sonographic brachial artery assessment and blood sampling. Smoothed gender-specific FMD percentile curves were constructed using the Lambda-Mu-Sigma (LMS) method. Predictive factors of FMD were identified using linear regression analysis.

RESULTS

Mean FMD among children and adolescents in the community setting was 8.57 ± 0.90%. Smoothed gender-specific FMD in centiles were constructed as a reference benchmark. Regression analysis after adjustment for age, gender, body mass index (BMI) z-score, and baseline artery diameter, when applicable, demonstrated that FMD is positively correlated with age (β = 0.142, p < 0.001, 95% CI [0.081-0.203]) and high density lipoprotein (HDL) (β = 0.103, p = 0.001, 95% CI [0.041-0.165]), while negatively correlated with baseline artery diameter (β = -0.117, p = 0.001, 95% CI [-0.189 - -0.046]), diastolic blood pressure (DBP) (β = -0.053, p = 0.047, 95% CI [-0.105 - -0.001]), glucose (β = -0.091, p = 0.004, 95% CI [-0.153 - -0.030]) and triglyceride (TG) (β = -0.138, p < 0.001, 95% CI [-0.198 - -0.078]). Multivariate regression analysis showed that age, baseline artery diameter, DBP, glucose and TG were independent predictors of FMD.

CONCLUSIONS

Normative reference values for FMD were constructed with predictive factors identified for children and adolescents.

摘要

背景

我们旨在确定儿童和青少年肱动脉血流介导的血管舒张功能（FMD）按年龄和性别的正常参考值，并确定该人群中FMD的预测因素。

方法

招募了1498名年龄在8至17岁的健康儿童和青少年作为代表性样本。受试者接受了肱动脉超声评估和血液采样。使用Lambda-Mu-Sigma（LMS）方法构建了按性别划分的FMD平滑百分位数曲线。使用线性回归分析确定FMD的预测因素。

结果

社区环境中儿童和青少年的平均FMD为8.57±0.90%。构建了按性别划分的FMD平滑百分位数作为参考基准。在适当时对年龄、性别、体重指数（BMI）z评分和基线动脉直径进行调整后的回归分析表明，FMD与年龄呈正相关（β = 0.142，p < 0.001，95%可信区间[0.081 - 0.203]）和高密度脂蛋白（HDL）呈正相关（β = 0.103，p = 0.001，95%可信区间[0.041 - 0.165]），而与基线动脉直径呈负相关（β = -0.117，p = 0.001，95%可信区间[-0.189 - -0.046]）、舒张压（DBP）呈负相关（β = -0.053，p = 0.047，95%可信区间[-0.105 - -0.001]）、血糖呈负相关（β = -0.091，p = 0.004，95%可信区间[-0.153 - -0.030]）和甘油三酯（TG）呈负相关（β = -0.138，p < 0.001，95%可信区间[-0.198 - -0.078]）。多变量回归分析表明，年龄、基线动脉直径、DBP、血糖和TG是FMD的独立预测因素。