Impaired microvascular function in normal children: effects of adiposity and poor glucose handling
Impaired microvascular function in normal children: effects of adiposity and poor glucose handling
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DOI：
10.1113/jphysiol.2003.045351
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发表时间：
2003-09-01
影响因子：
5.5
通讯作者：
Belch, JJF
中科院分区：
文献类型：
--
作者：
Khan, F;Green, FC;Belch, JJF
心血管危险因素的聚集被认为发生在生命早期。内皮是微血管功能的重要调节者。我们调查了 145 名 11-14 岁正常健康儿童的微血管功能与心血管危险因素之间的关系。使用激光多普勒成像测量的皮肤微血管对乙酰胆碱 (ACh) 和硝普钠 (SNP) 离子电渗疗法的反应与体脂百分比呈负相关（分别为 r = -0.20，P < 0.05 和 r = -0. 18，P < 0.05）。根据喂食后 2 小时的血糖水平，将受试者分为五等分。处于较高葡萄糖五分位数（范围 7.4-11.4 mmol l(-1)）的受试者对 ACh（P < 0.005）和 SNP（P < 0.02）的血管舒张作用显着低于处于较低五分位数（范围 3.9-4.9 mmol l(-1)）的受试者。上五分位受试者的腰臀比和空腹胰岛素抵抗指数显着高于下五分位受试者（分别为 P < 0.001 和 P < 0.05）。此外，在血糖较高五分位数的受试者中，空腹甘油三酯与空腹胰岛素（r = 0.59，P < 0.001）和空腹胰岛素抵抗指数（r = 0.49，P < 0.009）相关，血浆胆固醇和2小时血糖水平也相关（r = 0.40，P < 0.05）。在正常儿童的横截面中，微血管功能与肥胖呈负相关。此外，在一组受试者中，存在喂食后血糖高、微血管功能受损、胰岛素抵抗增加和中央脂肪分布较高的现象。这些发现表明，成人心血管疾病的危险因素开始聚集在正常儿童中，这可能对以后生活中动脉粥样硬化的发展产生重要影响。
Clustering of cardiovascular risk factors is thought to occur early in life. The endothelium is an important regulator of microvascular function. We investigated the relationship between microvascular function and cardiovascular risk factors in 145 normal, healthy children aged 11-14 years. Skin microvascular responses, measured using laser Doppler imaging, to iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP), were negatively correlated with percentage body fat (r = -0.20, P < 0.05 and r = -0. 18, P < 0.05, respectively). Subjects were stratified into quintiles based on 2-h, post-feeding glucose levels. Subjects in the upper glucose quintile (range 7.4-11.4 mmol l(-1)) showed significantly lower vasodilatation to both ACh (P < 0.005) and SNP (P < 0.02) than those in the lower quintile (range 3.9-4.9 mmol l(-1)). Waist-to-hip ratio and the fasting insulin resistance index were significantly greater in subjects in the upper quintile than those in the lower quintile (P < 0.001 and P < 0.05, respectively). Additionally, in subjects in the upper glucose quintile, fasting triglyceride correlated with fasting insulin (r = 0.59, P < 0.001) and with the fasting insulin resistance index (r = 0.49, P < 0.009), and plasma levels of cholesterol and 2-h glucose were also correlated (r = 0.40, P < 0.05). In a cross-section of normal children, microvascular function was negatively associated with adiposity. Additionally, in a subgroup of subjects, there was a clustering of high post-feeding glucose, impaired microvascular function, increased insulin resistance and higher central fat distribution. These findings suggest that risk factors for adult cardiovascular disease begin to cluster in normal children, which might have important consequences for development of atherosclerosis later in life.