CV RISK FACTORS/VASCULAR FUNCTION

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 颅内颈动脉（伊卡）钙化在常规头部CT扫描中经常在成人中发现。 它们与心血管风险因素密切相关，与血管造影血管狭窄相关，支持血管钙化是全身性动脉粥样硬化的标志物的观点。 即使是简单的牙科X光检查也可以识别与异常颈动脉超声相关的钙化，并预测随后的血管事件。 伊卡钙化在儿童中的意义尚不清楚，尽管放射科医生经常在头部CT扫描中识别它们，并且一项小型儿科尸检研究发现此类病变的患病率很高。 这些数据使我们假设儿童伊卡钙化代表早期动脉粥样硬化改变。 我们将进行一项病例对照研究，从接受颞骨CT扫描的现有儿童数据库中选择受试者，以验证这一理论。 由儿科放射科医生评价2年内收集的这些扫描是否存在伊卡钙化。 在408名儿童中，27%有钙化，尽管只有1名有可能解释这些发现的中等疾病（糖尿病和血脂异常）。 将研究50例病例和50例对照，其中12的受试者较年轻（6至12岁），12的受试者较年长（12至19岁），共计100例。 将收集人口统计学、病史和家族史、人体测量学和血压数据。 实验室分析将包括钙、磷、葡萄糖和胰岛素水平、空腹血脂、高灵敏度CRP、同型半胱氨酸和纤维蛋白原。 测试的中心和外周血管部位将包括颈动脉内中膜厚度和顺应性、主动脉扩张指数、肱动脉扩张性和手臂、躯干和腿部的脉搏波速度。 将进行分析，以确定伊卡钙化儿童是否1）显示血管功能的其他异常; 2）CV风险因素水平异常; 3）血管异常是否与CV风险因素水平相关。 还将通过比较病例与对照之间的钙-磷酸产物、全身炎症、纤维蛋白原和同型半胱氨酸水平来探讨早期血管钙化和功能障碍的潜在机制。 这项研究将使我们能够确定血管钙化作为儿童早期动脉粥样硬化疾病标志物的重要性，从而对高危人群进行早期干预，以预防未来不良心脏和卒中相关结局。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Calcifications of the intra-cranial carotid arteries (ICA) are frequently found in adults on routine head CT scans. They correlate strongly with CV risk factors & are associated with angiographic vessel stenosis supporting the idea that vascular calcifications are a marker for generalized atherosclerosis. Even simple dental X-rays may identify calcifications which relate to abnormal carotid ultrasound & predict subsequent vascular events. The significance of ICA calcifications in children is not known eve though radiologist frequently recognize them on head CT scans and one small pediatric autopsy study found a high prevalence of such lesions. These data led us to hypothesize that ICA calcifications in children represent early atherosclerotic change. We will test this theory by performing a case-control study selecting subjects from an existing database of children who underwent a temporal bone CT scan. These scans collected over 2 years, were evaluated by Pediatric Radiologist for presence of ICA calcification. Of 408 children, 27% had calcification although only 1 had a medial condition that might explain the findings (diabetes and dyslipidemia). Fifty cases & fifty controls will be studies with 1/2 of the subject younger (6 to 12 years) and 1/2 older (12 to 19 years) for a total of 100. Demographics, medical and family history, anthropometrics & blood pressure data will be collected. Laboratory analyses will include calcium, phosphorus, glucose & insulin levels, fasting lipid panel, high sensitivity CRP, homocysteine & fibrinogen. Central & peripheral vascular sites tested will include carotid intimate-media thickness & compliance, aortic augmentations index, brachial artery distensibility & pulse wave velocity to the arm, trunk & leg. Analyses will be performed to determine if children with ICA calcification 1) demonstrate other abnormalities in vascular function; 2) have abnormal levels of CV risk factors; and 3) whether vascular abnormalities correlate with levels of CV risk factors. Potential mechanisms underlying early vascular calcifications and dysfunction will also be explored by comparing calcium-phosphate product, levels of systemic inflammation, fibrinogen and homocysteine between cases & controls. The proposed research will allow us to determine the importance of vascular calcification as a marker for early atherosclerotic disease in children allowing earlier intervention in high risk individuals to prevent future adverse cardiac and stroke-related outcomes.