ARTERIAL ENDOTHELIAL FUNCTION--AN EPIDEMIOLOGIC STUDY

许多青年受试者有不同程度的动脉粥样硬化性冠状动脉和颈动脉疾病， 没有任何症状。随着时间的推移，许多人突然和意外地死亡，治疗作用有限。 一旦出现有症状的冠心病和中风，就可以选择。自动脉粥样硬化以来 这一过程始于青年，衡量动脉粥样硬化的早期表现可能具有潜在的 在治疗时确定早期冠状动脉和颈动脉闭塞性血管疾病的风险 可以管理选项。肱动脉血流介导的扩张性(FMD)功能受损 研究表明，高胆固醇血症、高同型半胱氨酸血症、糖尿病和糖尿病的儿童和年轻人中存在 在那些吸烟的人身上。臂动脉FMD受损已被证明与内皮功能受损有关， 这是动脉粥样硬化过程的早期表现。如果臂动脉FMD受损是一个预测因子 这一过程，然后它可以用来无创地评估动脉粥样硬化的早期发展和 评估治疗干预措施的效果。 在马斯卡汀研究的600名成年人中，年龄在35岁到43岁之间，他们的风险因素被测量 在儿童期和成年期，我们建议测量同时期的危险因素，以及臂部 动脉FMD、冠状动脉钙化(CAC)和颈动脉内中膜厚度(IMT) (后两种方法确定了早期动脉粥样硬化的指标)，并在3年后再次进行。这一努力是精心设计的 检验以下假设：1)确定的危险因素水平在儿童、成年和 从儿童期到成年期均可预测臂动脉FMD；2)推定的风险 成年时测量的因子水平与肱动脉FMD、CAC和颈动脉的程度有关 结论：1)颈动脉内膜中层厚度与颈动脉内膜厚度呈正相关，与颈动脉内膜厚度呈正相关； 预测颈动脉IMT增加。 这份申请是对以前作为另一项拨款的补充提交的申请的修订。

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 options are available once symptomatic coronary heart disease and stoke occur. Since the atherosclerotic process begins in youth, a measure of the early manifestations of atheroscleosis 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 relate 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 from 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. This application is a revision of one previously submitted as a supplement to another grant.