Associations of coronary heart disease risk factors with the intermediate lesion of atherosclerosis in youth
Associations of coronary heart disease risk factors with the intermediate lesion of atherosclerosis in youth
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DOI：
10.1161/01.atv.20.8.1998
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发表时间：
2000-08-01
影响因子：
8.7
通讯作者：
Strong, JP
中科院分区：
文献类型：
--
作者：
McGill, HC;McMahan, CA;Strong, JP
隆起的脂肪条纹（脂肪斑）是介于幼年（扁平）脂肪条纹和动脉粥样硬化隆起病变之间的病变的大体术语。我们测量了2876例年龄在15 ~ 34岁之间死于外部原因的尸检患者的动脉粥样硬化和右冠状动脉中平坦脂肪条纹、隆起脂肪条纹和隆起病变的内膜表面百分比。在15- 19岁受试者中，约20%的受试者的腹部动脉中存在隆起的脂肪条纹，而在30- 34岁受试者中，该百分比增加至约40%。在15- 19岁受试者中，约10%的受试者的右冠状动脉中存在隆起的脂肪条纹，而对于30- 34岁的受试者，这一比例增加到约30%。在两条动脉中，随着年龄的增长，涉及脂肪条纹的内膜表面百分比增加，并且与腹主动脉和右冠状动脉中的高非高密度脂蛋白（HDL）和低HDL胆固醇浓度相关，与腹主动脉高血压相关，与男性右冠状动脉肥胖相关，与右冠状动脉葡萄糖耐量受损相关。在青少年后期的受试者中，风险因素与脂肪条纹凸起的相关性变得明显，而风险因素与病变凸起的相关性在年龄>25岁的受试者中变得明显。这些结果与假定的脂肪条纹的过渡作用一致，并表明冠心病危险因素加速了生命第二个十年的动脉粥样硬化形成。因此，动脉粥样硬化的长期预防应该从儿童或青少年开始开始。
The raised fatty streak (fatty plaque) is the gross term for the lesion intermediate between the juvenile (flat) fatty streak and the raised lesion of atherosclerosis. We measured the percentage of intimal surface involved with flat fatty streaks, raised fatty streaks, and raised lesions in the aortas and right coronary arteries of 2876 autopsied persons aged 15 through 34 years who died of external causes. Raised fatty streaks were present in the abdominal aortas of approximate to 20% of 15- to 19-year-old subjects, and this percentage increased to approximate to 40% for 30- to 34-year-old subjects, Raised fatty streaks were present in the right coronary arteries of approximate to 10% of 15- to 19-year-old subjects, and this percentage increased to approximate to 30% for 30- to 34-year-old subjects. The percent intimal surface involved with raised fatty streaks increased with age in both arteries and was associated with high non-high density lipoprotein (HDL) and low HDL cholesterol concentrations in the abdominal aorta and right coronary artery, with hypertension in the abdominal aorta, with obesity in the right coronary artery of men, and with impaired glucose tolerance in the right coronary artery. Associations of risk factors with raised fatty streaks became evident in subjects in their late teens, whereas associations of risk factors with raised lesions became evident in subjects aged >25 years. These results are consistent with the putative transitional role of raised fatty streaks and show that coronary heart disease risk factors accelerate atherogenesis in the second decade of life. Thus, long-range prevention of atherosclerosis should begin in childhood or adolescence.