Determinants of atherosclerosis in the young. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group.
Determinants of atherosclerosis in the young. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group.
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发表时间：
1998
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通讯作者：
H. Mcgill;C. Mcmahan
中科院分区：
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作者：
H. Mcgill;C. Mcmahan
一项多中心合作研究，青年动脉粥样硬化的病理生物学决定因素，研究了近 3,000 名 15-34 岁的成人冠状动脉疾病危险因素与动脉粥样硬化的关系，这些人死于事故、他杀和自杀，并在法医实验室进行了尸检。极低密度脂蛋白 (VLDL) 加低密度脂蛋白 (LDL) 胆固醇水平呈正相关，而高密度脂蛋白 (HDL) 胆固醇水平呈负相关，与脂肪条纹以及主动脉和右冠状动脉的凸起病变相关，特别是在 25 岁之后。在整个 15-34 岁的年龄范围内，糖化血红蛋白水平升高与凸起病变相关。男性的体重指数与脂肪条纹和右冠状动脉凸起病变相关，但女性则不然。在 25-34 岁年龄组中，吸烟与腹主动脉隆起病变增加 3 倍相关。女性右冠状动脉病变程度较男性晚约 5 年，但除肥胖外，女性危险因素的影响与男性相似。成人冠状动脉疾病的危险因素会加速青少年时期动脉粥样硬化的形成，其影响在成年早期即冠状动脉疾病出现临床症状之前的 20-30 年内会放大。成人冠状动脉疾病的长期预防需要在生命早期控制危险因素。
A multicenter cooperative study, Pathobiological Determinants of Atherosclerosis in Youth, examined the relation of the risk factors for adult coronary artery disease to atherosclerosis in nearly 3,000 persons, aged 15-34 years, who died from accidents, homicides, and suicides and were autopsied in forensic laboratories. Very-low-density lipoprotein (VLDL) plus low-density lipoprotein (LDL) cholesterol levels were positively, and high-density lipoprotein (HDL) cholesterol levels were negatively, associated with both fatty streaks and raised lesions in the aorta and right coronary artery, particularly after age 25. Elevated glycohemoglobin levels were associated with raised lesions throughout the 15-34-year age span. Body mass index was associated with both fatty streaks and raised lesions of the right coronary artery in men but not in women. Smoking was associated with a 3-fold increase in raised lesions of the abdominal aorta in the 25-34-year age group. Women lagged after men in the extent of raised lesions in the right coronary artery by about 5 years, but the effects of risk factors in women, except for adiposity, were similar to those in men. The risk factors for adult coronary artery disease accelerate atherogenesis in the teenage years and their effects are amplified in young adulthood, 20-30 years before coronary artery disease becomes clinically manifest. Long-range prevention of adult coronary artery disease will require control of the risk factors early in life.