Associations of dyslipidemias from childhood to adulthood with carotid intima-media thickness, elasticity, and brachial flow-mediated dilatation in adulthood -: The Cardiovascular Risk in Young Finns Study
Associations of dyslipidemias from childhood to adulthood with carotid intima-media thickness, elasticity, and brachial flow-mediated dilatation in adulthood -: The Cardiovascular Risk in Young Finns Study
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DOI：
10.1161/atvbaha.108.163329
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发表时间：
2008-05-01
影响因子：
8.7
通讯作者：
Raitakari, Olli T.
中科院分区：
文献类型：
--
作者：
Juonala, Markus;Viikari, Jorma S. A.;Raitakari, Olli T.
背景：血脂异常是动脉粥样硬化的主要原因。它们可能与非脂质危险因素协同作用，增加动脉粥样硬化的发生。在本研究中，我们研究了从儿童期到成年期血脂异常的影响及其与非脂质危险因素对亚临床动脉粥样硬化标志物的相互作用。方法和结果：研究对象是1980年开始的芬兰青年心血管风险纵向研究（n = 2265，年龄3 - 18岁）的参与者。对于IIa型、IIb型和IV型血脂异常和低高密度脂蛋白胆固醇血症，我们计算了1980年、1983年、1986年和2001年每个受试者的年龄和性别特异性脂质值z分。ldl -胆固醇或甘油三酯的平均z分超过90百分位数的受试者被认为患有IIa型或IV型血脂异常。ldl -胆固醇和甘油三酯平均z分超过90百分位数的受试者为IIb型血脂异常，hdl -胆固醇平均z分低于10百分位数的受试者为低hdl -胆固醇血症。与对照组相比，IIb型血脂异常患者颈动脉IMT增高（P < 0.01）。在校正其他危险因素后，这一差异仍然显著（P < 0.05）。与对照组相比，IIb型患者颈动脉IMT随着非脂质危险因素数量的增加（P < 0.001）或代谢综合征的存在（P < 0.05）而显著增加。IIb型或IV型血脂异常患者颈动脉弹性降低（P < 0.05），但与血压校正后差异不显著（P < 0.05）。结论：我们的研究结果表明，IIb型血脂异常从儿童时期就已经对血管系统产生了有害影响。IIb型血脂异常患者更容易受到心血管危险因素和代谢综合征的影响。
Background-Dyslipidemias are the major cause for atherosclerosis. They may act synergistically with nonlipid risk factors to increase atherogenesis. In the present study, we examined the effects of dyslipidemias from childhood to adulthood and their interaction with nonlipid risk factors on markers of subclinical atherosclerosis.Methods and Results-Study subjects were participants of the longitudinal Cardiovascular Risk in Young Finns Study started in 1980 (n = 2265, age 3 to 18 years). To phenotype type IIa, IIb, and IV dyslipidemias and hypoHDL-cholesterolemia, we calculated age and sex-specific z scores for lipid values for each subject in 1980, 1983, 1986, and 2001. Subjects with mean z score over 90th percentile for LDL-cholesterol or triglycerides were considered having type IIa or IV dyslipidemia. Subjects with mean z score over 90th percentile for LDL-cholesterol and triglycerides had type IIb dyslipidemia, and those with mean z score below 10th percentile for HDL-cholesterol had hypoHDL-cholesterolemia. Compared to controls, subjects with type IIb dyslipidemia had increased carotid IMT (P < 0.01). This difference remained significant when adjusted with other risk factors (P < 0.05). Carotid IMT also increased significantly more with increasing number of nonlipid risk factors (P < 0.001) or presence of the metabolic syndrome (P < 0.05) in subjects with type IIb than in controls. Subjects with type IIb or type IV dyslipidemia had decreased carotid elasticity (P < 0.05), but these differences became nonsignificant (P > 0.3) when adjusted with blood pressure.Conclusions-Our findings suggest that type IIb dyslipidemia has deleterious effects on vasculature already since childhood. Subjects with type IIb dyslipidemia are more vulnerable to the effects of cardiovascular risk factors and metabolic syndrome.