ARTERIAL ENDOTHELIAL FUNCTION--AN EPIDEMIOLOGIC STUDY

许多年轻的成年受试者具有一定程度的动脉粥样硬化性冠状动脉， 颈动脉疾病，没有任何症状。随着时间的推移，许多 突然意外死亡，只有有限的治疗过程开始 在年轻人中，动脉粥样硬化早期表现的测量可能 有可能识别出有早发冠状动脉粥样硬化风险的受试者 和颈动脉闭塞性血管疾病时， 管理。肱动脉血流介导的舒张功能（FMD）受损 儿童和年轻人的能力已经被证明是存在的， 高胆固醇血症、高同型半胱氨酸血症、糖尿病， 抽烟肱动脉FMD受损已被证明与受损的 内皮功能，这是一个早期的表现， 动脉粥样硬化过程如果肱动脉FMD受损是 这个过程，那么它可以用来非侵入性地评估动脉粥样硬化， 在其发展的早期，并评估治疗的效果 干预措施。 在一组来自马斯卡廷的600名35至43岁的成年人中， 研究，其风险因素在儿童和年轻时进行了测量 成年后，我们建议测量同期的风险因素， 肱动脉FMD，沿着冠状动脉钙化（CAC）， 颈动脉内膜中层厚度（IMT）（后两者建立 早期动脉粥样硬化的测量）和3年后再次测量。这一努力是 旨在检验以下假设：1）既定的风险因素 在儿童期、成年期和不同年龄段测量的水平 儿童期至成年期是肱动脉FMD的预测指标; 2） 在成年期测量的假定风险因素水平与 肱动脉FMD、CAC和颈动脉IMT的程度; 成人动脉FMD、CAC与颈动脉IMT相关; 肱动脉FMD可预测颈动脉IMT增加。

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.