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和颈动脉疾病， 没有任何症状。随着时间的推移，许多人突然意外死亡， 一旦出现有症状的冠心病和斯托克，就可以选择。因为动脉粥样硬化 由于动脉粥样硬化的过程始于青年，因此动脉粥样硬化早期表现的测量可能具有以下潜力： 在治疗时识别处于早发冠状动脉和颈动脉闭塞性血管疾病风险的受试者 可以管理选项。肱动脉血流介导的舒张（FMD）能力受损， 显示存在于患有高胆固醇血症、高同型半胱氨酸血症、糖尿病和 在那些吸烟的人身上。肱动脉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。如果肱动脉FMD受损是 这一过程，那么它可以用来非侵入性地评估动脉粥样硬化的早期发展， 评估治疗干预的效果。 在马斯卡廷研究的600名年龄在35至43岁的成年人中， 在儿童期和青年期，我们建议测量同期的危险因素， 动脉FMD，沿着冠状动脉钙化（CAC）和颈动脉内膜-中层厚度（IMT） (the后两项建立了早期动脉粥样硬化的测量方法），并在3年后再次进行。这项工作旨在 检查以下假设：1）在儿童期，成年期和成年期测量的既定风险因素水平 从儿童期到成年期的平均年龄预测肱动脉FMD; 2）推定风险 成年期测量的因子水平与肱动脉FMD、CAC和颈动脉的程度有关 成人肱动脉FMD、CAC与颈动脉IMT相关; 预测颈动脉IMT增加。 这份申请是对以前提交的另一份补助金的补充申请的修改。

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.