ARTERIAL ENDOTHELIAL FUNCTION--AN EPIDEMIOLOGIC STUDY

许多年轻的成年受试者有不同程度的动脉粥样硬化的冠状动脉和 颈动脉疾病，没有任何症状。随着时间的推移，许多人 突然和意外死亡，只开始了有限的治疗过程 在年轻人中，动脉粥样硬化早期表现的一种衡量标准可能是 有可能确定有过早冠状动脉病变风险的受试者 和颈动脉闭塞性血管疾病时的治疗选择 管理。肱动脉血流介导的扩张性受损 已有研究表明，儿童和年轻人中存在这种能力 高胆固醇血症、高同型半胱氨酸血症、糖尿病和那些 烟。臂动脉FMD受损已被证明与受损有关 内皮功能，这是高血压的早期表现 动脉粥样硬化过程。如果臂动脉FMD受损是一个预测因子 这一过程，则可用于无创性地评估动脉粥样硬化 并评价其治疗效果。 干预措施。 在来自马斯卡廷的600名成年人中，年龄在35岁到43岁之间 研究，其风险因素在儿童和青年时期进行了测量 成年后，我们建议测量同时的风险因素，并且 臂动脉FMD与冠状动脉钙化(CAC)和 颈动脉内中膜厚度(IMT)(后两者建立 早期动脉粥样硬化的测量)，并在3年后再次。这一努力是 旨在检验以下假设：1)已确定的风险因素 在儿童期、成年期和各年龄段测量的水平 从童年到成年都预示着臂动脉FMD；2) 在成年期测量的假定危险因素水平与 3)肱动脉FMD、CAC和颈动脉IMT的程度 成人动脉FMD、CAC和颈动脉IMT相关； 肱动脉FMD是颈动脉IMT增加的预测指标。

Many young adult subjects have some degree of atherosclerotic coronary and carotid artery disease and experience no symptoms. As time passes, many die suddenly and unexpectedly and only limited therapeutic process begins in youth, a measure of the early manifestations of atherosclerosis may have the potential of identifying subjects at risk for premature coronary and carotid occlusive vascular disease when therapeutic options can be administered. Impaired brachial artery flow mediated dilatory (FMD) capacities have been shown to exist in children and young adults with hypercholesterolemia, hyperhomocysteinemia, diabetes and in those who smoke. Impaired brachial artery FMD has been shown to related to impaired endothelial function, which is an early manifestation of the atherosclerotic process. If impaired brachial artery FMD is a predictor of the process, then it may be used to non-invasively assess atherosclerosis early in its development and to evaluate the effect of therapeutic interventions. In a cohort of 600 adults, 35 to 43 years of age, from the Muscatine Study, whose risk factors were measured during childhood and young adulthood, we propose to measure contemporaneous risk factors, and brachial artery FMD, along with coronary artery calcification (CAC) and carotid artery intimal-medial thickness (IMT) (the latter two established measures of early atherosclerosis) and again 3 years later. This effort is designed to examine the following hypotheses: 1) Established risk factor levels measured in childhood, adulthood and across the years form childhood through adulthood are predictive of brachial artery FMD; 2) Putative risk factor levels measured in adulthood are related to the degree of brachial artery FMD, CAC and carotid artery IMT; 3) Brachial artery FMD, CAC and carotid artery IMT are related in adults; and 4) Brachial artery FMD is predictive of increased carotid artery IMT.