Early lesions of atherosclerosis in childhood and youth: natural history and risk factors.
Early lesions of atherosclerosis in childhood and youth: natural history and risk factors.
复制标题
儿童和青少年动脉粥样硬化的早期病变：自然史和危险因素。
DOI：
10.1080/07315724.1992.10737984
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发表时间：
1992
影响因子：
3.5
通讯作者：
Oalmann,MC
中科院分区：
文献类型：
--
作者：
Strong,JP;Malcom,GT;Newman3rd,WP;Oalmann,MC
本文追溯了有关动脉粥样硬化早期病变知识的发展，以及与儿童、青年和年轻人危险因素的关系。尸检研究表明，动脉粥样硬化始于童年，出现主动脉脂肪条纹。不同程度的主动脉脂肪条纹几乎存在于每个人群的所有个体中。冠状脂肪条纹开始形成于青春期。大多数20-29岁的人都有一定程度的冠状动脉脂肪条纹，无论性别，种族或民族血统如何。虽然脂肪条纹在临床上是无害的，并且可能是可逆的，但进展为纤维斑块和更晚期的病变通常会导致动脉粥样硬化的关键阶段，其中临床疾病发展。纤维斑块的发展开始于20年代。最新的青年和年轻人动脉粥样硬化的研究提供了更多的细节，以建立这些病变的关系，血脂和脂蛋白和其他确定的危险因素的动脉粥样硬化和冠心病的成年人。一份报告显示，大多数10-14岁儿童的冠状动脉左前降支出现显微镜下对应的脂肪条纹。超过5%的人在这个年龄段有更严重的显微镜病变。青年尸检研究表明，血清总胆固醇和低密度脂蛋白胆固醇水平与主动脉脂肪纹密切相关，极低密度脂蛋白胆固醇水平与冠状动脉脂肪纹呈正相关。最后，一份权威性的报告指出，血清脂蛋白胆固醇浓度和吸烟是青少年和年轻人动脉粥样硬化早期阶段的重要决定因素。
This paper traces the development of knowledge concerning early lesions of atherosclerosis and the relationship to risk factors in children, youth, and young adults. Autopsy studies have shown that atherosclerosis begins in childhood with the appearance of aortic fatty streaks. Aortic fatty streaks of some degree are present in practically all individuals from every human population. Coronary fatty streaks begin to form in adolescence. Most persons 20-29 years of age have coronary fatty streaks of some degree, regardless of sex, race, or national origin. While fatty streaking is clinically harmless and potentially reversible, progression to fibrous plaques and more advanced lesions often leads to a critical stage of atherosclerosis in which clinical disease develops. Development of fibrous plaques begins in the 20s. The most recent studies of atherosclerosis in youth and young adults provide additional details to establish the relationship of these lesions to serum lipids and lipoproteins and other identified risk factors for atherosclerosis and coronary heart disease in adults. One report shows that microscopic counterparts of fatty streaks occur in the left anterior descending coronary artery in the majority of children 10-14 years of age. Over 5% have more advanced microscopic lesions at this age. Autopsy studies of youth have shown that serum total cholesterol and low-density lipoprotein cholesterol levels are strongly related to aortic fatty streaks and the very-low-density lipoprotein cholesterol levels are positively correlated to coronary artery fatty streaks. Finally, a definitive report indicates that serum lipoprotein cholesterol concentrations and smoking are important determinants of the early stages of atherosclerosis in adolescents and young adults.