Gariepy J, Simon A, Massonneau M, Linhart A, Levenson J
Centre de Médecine Préventive Cardio-vasculaire, INSERM U 28, Hôpital Broussais, Paris, France.
Atherosclerosis. 1995 Mar;113(2):141-51. doi: 10.1016/0021-9150(94)05436-m.
This study was performed to determine whether hypercholesterolemic men had increased large artery intima-media thickness (IMT), a potential surrogate measure of atherosclerosis, compared to normocholesterolemic controls. The measurements were performed in the far walls of common carotid and femoral arteries with non-invasive automatic computerized ultrasonic technique in 101 asymptomatic men (28-60 years) of whom 40 were normocholesterolemic (total cholesterol < 5.2 mmol/l, controls), 25 had borderline hypercholesterolemia (5.2 < or = total cholesterol < 6.2 mmol/l, group 1) and 36 had hypercholesterolemia (total cholesterol > or = 6.2 mmol/l, group 2). All the subjects had no other traditional risk factors, except smoking. Carotid and femoral IMT were significantly increased in group 2 (P < 0.01) but not in group 1 compared to controls. When all subjects were pooled for analysis, carotid and femoral IMT were correlated (r = 0.47, P < 0.001) and increased with total cholesterol (r = 0.35, P < 0.001) and LDL cholesterol (r = 0.33, r = 0.34, respectively; P < 0.001). Carotid and femoral IMT increased with age in each group: controls, r = 0.46, P < 0.01 and r = 0.50, P < 0.001, respectively; group 1, r = 0.42, P < 0.05; group 2, r = 0.48, P < 0.01, and r = 0.59, P < 0.001, respectively. At the carotid and femoral sites, the regression slopes between age and IMT were steeper in group 2 than in controls (P < 0.01). Thus, hypercholesterolemia was associated with diffuse large artery wall thickening, whose presence might be useful in the identification of those hypercholesterolemic individuals most prone to developing atheromatous changes, in the decision to treat, and in the monitoring of lipid-lowering treatment.
本研究旨在确定与血脂正常的对照组相比，高胆固醇血症男性的大动脉内膜中层厚度（IMT）是否增加，IMT是动脉粥样硬化的一个潜在替代指标。采用非侵入性自动计算机超声技术，对101名无症状男性（28 - 60岁）的颈总动脉和股动脉远壁进行测量，其中40名血脂正常（总胆固醇<5.2 mmol/l，对照组），25名处于边缘性高胆固醇血症（5.2≤总胆固醇<6.2 mmol/l，第1组），36名患有高胆固醇血症（总胆固醇≥6.2 mmol/l，第2组）。除吸烟外，所有受试者均无其他传统危险因素。与对照组相比，第2组的颈动脉和股动脉IMT显著增加（P<0.01），而第1组未增加。当将所有受试者汇总进行分析时，颈动脉和股动脉IMT呈正相关（r = 0.47，P<0.001），并随总胆固醇（r = 0.35，P<0.001）和低密度脂蛋白胆固醇（分别为r = 0.33，r = 0.34；P<0.001）升高。每组中颈动脉和股动脉IMT均随年龄增加：对照组分别为r = 0.46，P<0.01和r = 0.50，P<0.001；第1组为r = 0.42，P<0.05；第2组分别为r = 0.48，P<0.01和r = 0.59，P<0.001。在颈动脉和股动脉部位，第2组年龄与IMT之间的回归斜率比对照组更陡（P<0.01）。因此，高胆固醇血症与弥漫性大动脉壁增厚有关，其存在可能有助于识别那些最易发生动脉粥样硬化改变的高胆固醇血症个体、指导治疗决策以及监测降脂治疗。
