Normative values for intima-media thickness and distensibility of large arteries in healthy adolescents
Normative values for intima-media thickness and distensibility of large arteries in healthy adolescents
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DOI：
10.1097/01.hjh.0000178834.26353.d5
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发表时间：
2005-09-01
影响因子：
4.9
通讯作者：
Schaefer, F
中科院分区：
文献类型：
--
作者：
Jourdan, C;Wühl, E;Schaefer, F
目的 动脉壁形态和弹性的超声评估作为心血管评估中的一种非侵入性工具日益被接受。多项研究表明，内膜 - 中层厚度（IMT）和动脉弹性指数可能敏感地反映儿童不同的血管病变过程。然而，其正常参考值以及青少年生长的影响在很大程度上尚不明确。
方法 我们对247名10 - 20岁的健康受试者评估了颈总动脉（cIMT）和股动脉（fIMT）的内膜 - 中层厚度、颈动脉弹性指数以及相关的人体测量学因素。
结果 cIMT、fIMT、增量弹性模量（E - inc）和周向壁应力（CWS）与年龄、身高、体重指数（BMI）、收缩压（BP）和肱动脉脉压呈正相关，而扩张系数（DC）呈负相关（r = 0.56至 - 0.45，P < 0.05至0.0001）。DC（r = - 0.29，P < 0.0001）和僵硬度指数P（r = 0.25，P < 0.0001），但不包括Einc，与cIMT独立于年龄显著相关。所有血管参数均呈非高斯分布。过高的IMT与BMI和脉压高于第90百分位数相关，Einc升高与高正常BMI相关。多变量分析确定了标准化BMI和肱动脉脉压对标准化cIMT的独立正向影响，收缩压和cIMT对DC的负向影响，cIMT对僵硬度的正向影响，以及收缩压和BMI对E - inc和CWS的正向影响。
结论 大动脉的形态学和功能测量应标准化，以考虑青春期的变化和偏态分布。相对体重、收缩压和/或脉压是IMT和弹性的决定因素。（c）2005年利平科特·威廉姆斯和威尔金斯出版社。
Objective Sonographic evaluation of arterial wall morphology and elasticity is increasingly accepted as a non-invasive tool in cardiovascular assessment. Several studies suggest that intima-media thickness (IMT) and arterial elasticity indices may sensitively reflect different vasculopathic processes in children. However, normative values and the impact of adolescent growth are largely unknown.Methods We assessed the IMT of the common carotid (cIMT) and femoral arteries (fIMT), carotid elasticity indices and interacting anthropometric factors in 247 healthy subjects aged 10-20 years.Results cIMT, fIMT, incremental elastic modulus (E-inc) and circumferential wall stress (CWS) were positively, and distensibility coefficient (DC) inversely, correlated with age, height body mass index (BMI), systolic blood pressure (BP) and brachial pulse pressure (r = 0.56 to -0.45, P < 0.05 to 0.0001). DC (r = -0.29, P < 0.0001) and stiffness index P (r = 0.25, P < 0.0001), but not Einc, were significantly associated with cIMT independently of age. All vascular parameters showed non-Gaussian distributions. Excessively high IMT was associated with BMI and pulse pressure above the 90th percentile, and elevated Einc with high-normal BMI. Multivariate analysis identified independent positive effects of standardized BMI and brachial pulse pressure on normalized cIMT, negative effects of systolic BP and cIMT on DC, a positive effect of cIMT on stiffness, and positive effects of systolic BP and BMI on E-inc and CWS.Conclusions Morphological and functional measures of large arteries should be normalized to take account of changes during adolescence and skewed distributions. Relative body mass, systolic blood pressure and/or pulse pressure are determinants of IMT and elasticity. (c) 2005 Lippincott Williams & Wilkins.