Mmekọrịta dị n'etiti ahụike obi na vaskụla phenotype

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Mmekọrịta dị n'etiti ezigbo ahụike obi na vaskụla phenotype nke ndị nne buru ibu na ụmụ ha dị afọ 6
Ndị edemede: Litwin L, Sundholm JKM, Meinilä J, Kulmala J, Tammelin TH, Rönö K, Koivusalo SB, Eriksson JG, Sarkola T
Linda Litwin,1,2 Johnny KM Sundholm,1,3 Jelena Meinilä,4 Janne Kulmala,5 Tuija H Tammelin,5 Kristiina Rönö,6 Saila B Koivusalo,6 Johan G Eriksson,7–10 Taisto Sarkola1,31Ụlọ Ọgwụ ụmụaka, Mahadum nke Mahadum Helsinki na ụlọ ọgwụ mahadum Helsinki, Helsinki, Finland;2 Department of Congenital Heart Defects and Pediatric Cardiology, Silesian Medical University, Katowice, Poland, Zabrze FMS;3 Minerva Foundation Medical Research Institute, Helsinki, Finland;4 Ngalaba Nri na Nri, Mahadum Helsinki, Helsinki, Finland;5LIKES mmemme egwuregwu na ụlọ nyocha ahụike, Jyvaskyla, Finland;6 Ụlọ ọgwụ ụmụ nwanyị Helsinki na ụlọ ọgwụ mahadum Helsinki dị na Helsinki, Finland;7 Folkhälsan Research Center, Helsinki, Finland;8 Mahadum Helsinki na ngalaba Helsinki nke General Practice and Primary Health Care, ụlọ ọgwụ mahadum, Helsinki, Finland;9 Usoro nyocha mgbanwe mgbanwe mmadụ na ngalaba nke Obstetrics na Gynecology, Ụlọ Akwụkwọ Ọgwụ nke Yang Luling, Mahadum Mba nke Singapore, Singapore;10 Singapore Institute of Clinical Sciences (SICS), Science, Technology and Research Bureau (A*STAR), Singapore Communications: Linda Litwin Department of Congenital Heart Defects and Pediatric Cardiology, Zabrze FMS, Silesian Medical University, M.Sklodowskiej-Curie 9, Zabrze, 41-800. edoghị anya.Anyị bu n'obi nyochaa njikọ dị n'etiti ezigbo ahụike obi na ụmụaka na ndị nne, atherosclerosis subclinical nne, na arterial phenotypes na ụmụaka.Ụzọ: Site na Finnish Gestational Diabetes Prevention Study (RADIEL) longitudinal cohort, a cross-section analysis of 201 nne-nwa ụmụaka na 6.1 ± 0.5 afọ nke afọ enyochara ezigbo ahụike obi obi (BMI, ọbara mgbali, glucose ọbara na-ebu ọnụ, mkpokọta cholesterol, Nri nri, mgbatị ahụ, ise siga), ihe mejupụtara ahụ, carotid ultra-high ugboro ultrasound (25 na 35 MHz) na ebili mmiri pulse.Nsonaazụ: Anyị chọpụtara na ọ nweghị njikọ dị n'etiti ezigbo ahụike obi nke nwa na nne, mana kọrọ ihe akaebe nke njikọ nke ihe ngosi akọwapụtara: mkpokọta cholesterol (r=0.24, P=0.003), BMI (r=0.17, P) = 0.02), ọbara mgbali diastolic (r=0.15, P=0.03) na nri nri (r=0.22, P=0.002).Ụdị phenotype nke akwara ụmụaka enweghị ihe jikọrọ ya na ahụike obi obi dị mma nke nwatakịrị ma ọ bụ nne.N'ụdị nkọwa ntụgharị dị iche iche nke edoziri maka okike ụmụaka, afọ, ọbara mgbali systolic, oke anụ ahụ, na pasent abụba anụ ahụ, a na-ejikọta ọkpụrụkpụ nke akwara carotid intima-media na ụmụaka naanị n'onwe ya na ọkpụrụkpụ nke akwara carotid intima nne. -media (mmụba nke 0.1 mm [95%) CI 0.05, 0.21, P = 0.001] Ọkpụkpụ nke akwara carotid intima-media nke nne na-abawanye site na 1 mm).Ụmụaka ndị nne nwere atherosclerosis subclinical belatara mgbasa nke akwara carotid (1.1 ± 0.2 vs 1.2 ± 0.2% / 10 mmHg, P = 0.01) na ụbara akwara carotid intima-media ọkpụrụkpụ (0.37 ± 0.04 vs 0.35) ± 0.006 mm, P Mmechi: ezigbo ihe nleba anya ahụike obi na-ejikọta ya na ụzọ abụọ nne na nwa n'oge nwata.Anyị ahụghị ihe akaebe ọ bụla nke mmetụta ahụike ụmụaka ma ọ bụ nne nwere ezigbo ahụike obi na phenotypes akwara ụmụaka.Ọkpụkpụ akwara carotid intima-media nke nne nwere ike ibu amụma oke intima-media akwara carotid n'ime ụmụaka, mana usoro ya ka amabeghị.Atherosclerosis nke nne na-ahụ maka ime nwa nwere ihe jikọrọ ya na akwara carotid dị na mpaghara n'oge nwata.Keywords: ọrịa obi, atherosclerosis, carotid artery intima-media ọkpụrụkpụ, ihe ize ndụ, ụmụaka
Ihe ize ndụ obi nke ọdịnala na-enye aka na mmepe na mmepe nke atherosclerosis.1,2 Ihe ndị dị ize ndụ na-ejikọta ọnụ, na nchikota ha yiri ka ọ na-ebu amụma karịa ihe ize ndụ obi onye ọ bụla.3
Òtù Na-ahụ Maka Obi nke America na-akọwa ezigbo ahụike obi (ICVH) dị ka ihe ngosi ahụike asaa (BMI), ọbara mgbali elu (BP), glucose ọbara na-ebu ọnụ, mkpokọta cholesterol, àgwà nri, mmega ahụ, ịṅụ sịga) iji kwalite oge ochie. mgbochi ọrịa obi na ụmụaka na ndị okenye.4 A na-ejikọta IVH na-adịghị mma na atherosclerosis subclinical n'oge ntorobịa.5 ICVH na ọrịa phenotypes vaskụla na-adịghị mma bụ ndị amụma a pụrụ ịdabere na ya nke ihe omume obi na ọnwụ na ndị okenye.6-8
Ọrịa obi obi nke ndị nne na nna na-abawanye ohere nke ihe omume obi na ụmụ.9 A na-ahụta ihe ndị metụtara gburugburu ebe obibi metụtara mkpụrụ ndụ ihe nketa na ụdị ndụ nkịtị dị ka usoro nwere ike ime, mana ekpebibeghị onyinye ha.10,11
Mmekọrịta dị n'etiti nne na nna na nwa IPVH apụtalarị na ụmụaka dị afọ 11-12.N'oge a, ICVH ụmụaka na-ejikọta ya na carotid artery elasticity na mmetụta na-adịghị mma na cervical femoral pulse wave velocity (PWV), ma ọ dịghị egosipụta na carotid artery intima-media ọkpụrụkpụ (IMT).12 Otú ọ dị, ihe ize ndụ obi obi n'etiti 12-18 afọ na-ejikọta ya na mmụba nke carotid IMT na ndụ ndị agadi, ọ nweghịkwa ihe jikọrọ ya na ihe ndị dị ize ndụ n'otu oge ahụ.13 Ihe àmà na-egosi na mkpakọrịta ndị a siri ike n’oge ọ bụ nwata adịghị.
N'ime ọrụ anyị gara aga, anyị ahụghị mmetụta nke ọrịa shuga gestation ma ọ bụ usoro ndụ nne na nwata na anthropometry nwata, nhazi ahụ ma ọ bụ ogo akwara na ọrụ.14 Ihe nyocha a na-elekwasị anya bụ usoro n'ọgbọ nke mkpokọta ihe egwu obi.Klas na mmetụta ya na arterial phenotype nke ụmụaka.Anyị na-eche na ICVH nne na vaskụla vaskụla maka ọrịa obi ga-egosipụta na ICVH nwata na phenotypes arterial n'oge nwata.
Ihe omuma nke ozo sitere na nchikota afo isii nke Finnish Gestational Diabetes Prevention Study (RADIEL).Atụpụtala atụmatụ nyocha mbụ n'ebe ọzọ.15 Na nkenke, ụmụ nwanyị ndị na-eme atụmatụ ịtụrụ ime ma ọ bụ dị na ọkara mbụ nke ime ime ma nwee nnukwu ihe ize ndụ nke ọrịa shuga gestation (oke ibu na / ma ọ bụ akụkọ ihe mere eme nke ọrịa shuga gestational) ka a na-ewebata (N=728).Emebere ihe nleba anya nke afọ 6 nke obi dị ka ihe nleba anya nke ụzọ abụọ nne na nwa ọhụrụ, yana ọnụ ọgụgụ nha anya nke ndị nne nwere na ndị na-enweghị ọrịa shuga afọ ime, na-enwe oke otu ndị akọwapụtara (~ 200).Site na June 2015 ruo Mee 2017, a na-ezigara ndị sonyere akwụkwọ ịkpọ òkù na-aga n'ihu ruo mgbe oke ahụ ruru, na 201 ụzọ abụọ nke tuples abụọ ka a na-ewe.Emebere nsonazụ a maka ụmụaka ndị dị afọ 5-6 iji hụ na imekọ ihe ọnụ na-enweghị ịhịa aka n'ahụ, gụnyere ọnụọgụ ọnụọgụ abụọ nke nne na nwa ọhụrụ nke nha ahụ na ihe mejupụtara ya, ọbara mgbali elu, glucose ọbara na-ebu ọnụ na lipids ọbara, mmega ahụ site na iji accelerometers, ogo nri na nri. ajụjụ ndị na-ese anwụrụ (nne), arịa ọbara Ultrasound na intraocular mgbali n'ahụ na echocardiography na ụmụaka.Edepụtara nnweta data na tebụl mgbakwunye S1.Kọmiti ụkpụrụ omume nke Obstetrics na Gynecology, Pediatrics na Psychiatry nke Helsinki University Hospital kwadoro usoro nyocha (20/13/03/03/2015) maka nyocha nleba anya afọ isii.E nwetara nkwenye ederede nke ndị nne niile n'oge ndebanye aha.Emere ọmụmụ ihe a dịka nkwupụta Helsinki siri dị.
Onye na-eme nchọpụta nwere nkà (TS) na-eji 25 MHz na 35 MHz transducers na Vevo 770 usoro, na-eji UHF22, UHF48 (otu oge etiti etiti) na Vevo MD usoro (VisualSonics, Toronto, Canada) dị ka ikpeazụ 52 ụzọ abụọ nke nne na nwa.A na-ese onyinyo akwara carotid a na-ahụkarị 1 cm dị nso na bọlbụ carotid dị n'akụkụ, ebe izu ike dị n'elu.Jiri ugboro kachasị elu nke nwere ike iji anya nke uche hụ mgbidi dị anya iji nweta onyonyo ihe nkiri dị elu na-ekpuchi okirikiri obi 3-4.Jiri Vevo 3.0.0 (Vevo 770) jiri ntuziaka eletrọnịkị calipers na ngwa VevoLab (Vevo MD) nyochaa onyonyo na-anọghị n'ịntanetị.16 Lumen dayameta na IMT bụ onye na-ahụ ahụmahụ nwere ahụmahụ (JKMS) tụrụ na njedebe nke diastole site na iji usoro ịkpụcha ihe, na-amaghị njirimara isiokwu (Nkọwa S1).Anyị akọpụtala mbụ na ọnụọgụ intra-observer nke mgbanwe tụrụ site na ultra-high-resolution ultrasound na ụmụaka na ndị okenye bụ 1.2-3.7% na dayameta lumen, IMT bụ 6.9-9.8%, yana ọnụọgụ nke ihe dị iche iche nke inter-observer bụ. 1.5-4.6% na dayameta lumen., 6.0-10.4% nke IMT.A na-agbakọ akara carotid IMT Z maka afọ na okike site na iji ntụaka nke ụmụaka ọcha na-adịghị ahụkebe.17
A tụrụ dayameta carotid artery lumen na systole kacha elu na njedebe-diastole iji nyochaa akwara carotid β isi ike na ọnụọgụ mgbasawanye akwara carotid.N'iji eriri nha nke dabara adaba, a na-eji usoro oscillometric (Dinamap ProCare 200, GE) dekọọ ọbara mgbali systolic na diastolic maka ngụkọ arụmọrụ na-agbanwe n'oge onyonyo ultrasound n'akụkụ azụ nke ogwe aka nri.A na-agbakọ ọnụọgụ mgbasawanye nke akwara carotid na index carotid artery β-stiffness index site na akwara carotid site na iji usoro a:
N'ime ha, CCALAS na CCALAD bụ ebe a na-ahụkarị carotid artery lumen n'oge systole na diastole n'otu n'otu;CCALDS na CCALDD bụ dayameta carotid artery lumen n'oge systole na diastole n'otu n'otu;SBP na DBP bụ systolic na diastolic ọbara mgbali.18 Ọnụ ọgụgụ dị iche iche nke ọnụọgụ mgbasawanye nke akwara carotid na onye na-ekiri ya bụ 5.4%, ọnụọgụ nke mgbanwe nke carotid artery β stiffness index bụ 5.9%, na ọnụ ọgụgụ nke inter-observer nke mgbanwe nke mgbasawanye akwara carotid bụ 11.9% ọnụọgụgụ. na 12.8% nke akwara carotid β stiffness index.
Ultrasound Vivid 7 (GE) nke ọdịnala dị elu nke nwere transducer linear 12 MHz ka ejiri mee nyocha ọzọ maka akwara carotid nke nne maka plaque.Malite site na akwara carotid nkịtị dị nso na bọlbụ ahụ, a na-enyocha akwara carotid n'akụkụ abụọ site na bifurcation na akụkụ dị nso nke akwara carotid n'ime na n'èzí.Dị ka nkwenye Mannheim si kwuo, a kọwapụtara plaque dị ka 1. Mgbidi mpaghara nke mgbidi ụgbọ mmiri site na 0.5 mm ma ọ bụ 50% nke gburugburu IMT ma ọ bụ 2. Mkpokọta mgbidi akwara gafere 1.5 mm.19 A na-enyocha ọnụnọ nke plaque site na dichotomy.Onye na-ekiri ihe (JKMS) n'onwe ya na-eme nha ugboro ugboro na mpaghara ihe onyonyo (N = 40) iji nyochaa mgbanwe intra-observer, onye na-elele nke abụọ (TS) na-enyocha mgbanwe n'etiti ndị na-ekiri ihe.Cohen κ nke mgbanwe intra-observer na mgbanwe ndị na-ahụ anya bụ 0.89 na 0.83, n'otu n'otu.
A tụrụ PWV site n'aka onye nọọsụ na-eme nchọpụta a zụrụ azụ iji chọpụta isi ike akwara mpaghara site na iji ihe mmetụta igwe (Complior Analyse, Alam Medical, Saint-Quentin-Fallavier, France) ka ọ na-ezu ike n'ọnọdụ dị elu.20 A na-etinye sensọ na akwara carotid ziri ezi, akwara radial ziri ezi, na akwara femoral ziri ezi iji nyochaa etiti (canotid artery-femoral artery) na mpụta (ezigbo carotid artery-radial artery) oge ntụgharị.Jiri ihe teepu tụọ anya ozugbo n'etiti ebe ndekọ na 0.1 cm kacha nso.A na-amụba anya carotid femoral artery ziri ezi site na 0.8 wee jiri ya mee ihe na etiti etiti PWV.Tinyegharịa ndekọ ahụ n'ọkwa azụ.Enwetara ihe ndekọ abụọ mgbe e mere ndekọ nke atọ na ọnọdụ ebe ọdịiche dị n'etiti nha karịrị 0.5 m / s (10%).N'ime ntọala nke ihe karịrị nha abụọ, a na-eji nsonaazụ ya na uru ntachi obi dị ala maka nyocha.Nlegide anya bụ oke mma nke na-akọwapụta mgbanwe nke ebili mmiri n'oge ndekọ.Jiri nkezi nke opekata mpe abụọ na nyocha ikpeazụ.Enwere ike tụọ PWV nke ụmụaka 168.Ọnụ ọgụgụ nke mgbanwe nke nha ugboro ugboro bụ 3.5% maka akwara carotid-femoral PWV na 4.8% maka carotid-radial artery PWV (N=55).
A na-eji ihe ngosi ọnụọgụ atọ dị iche iche na-egosipụta atherosclerosis subclinical nke nne: ọnụnọ nke carotid artery plaque, carotid artery IMT gbanwere afọ ma gafere pasentị 90 na nlele anyị, yana ihe karịrị pasentị 90 PWV nke olu na femur kwekọrọ. na afọ na ezigbo ọbara mgbali.iri abụọ na otu
IPVH bụ ihe nrịbama ọnụọgụ asaa nke nwere ọnụọgụ ọnụọgụ sitere na 0 ruo 7 (ka akara ahụ dị elu, ka ọ dabara na ntuziaka).4 Ngosipụta IVCH ejiri mee ihe n'ọmụmụ ihe a kwekọrọ na nkọwa mbụ (mgbanwe atọ emela) -Mgbakwunye S2) ma gụnye:
A na-enyocha ogo nri nri site na Index nri nri ahụike ụmụaka Finnish (nsogbu 1-42) yana ndezi nri nri ahụike nne (nkeji 0-17).Ndekọ ndeksi abụọ ahụ kpuchiri 4 n'ime edemede 5 gụnyere na ihe ngosi nri izizi (belụsọ oriri sodium).23,24 A na-akọwa uru dị oke mkpa nke ezigbo nri nri na-adịghị mma dị ka 60% ma ọ bụ karịa iji gosipụta àgwà nke nri mbụ.Nkọwa ihe ngosi (ọ dị mma ma ọ bụrụ na ezutere ihe karịrị 3 n'ime njirisi ise).N'izo aka na ọnụ ọgụgụ ụmụaka ụmụaka Finnish ahụ siri ike na nso nso a (87.7% maka ụmụ agbọghọ, 78.2% maka ụmụ nwoke), ọ bụrụ na agafere oke oke okike maka ụmụaka buru oke ibu, a na-akọwa BMI nwata ahụ dị ka ihe na-adịghị mma, nke dịtụ iche na 85. % nke ndị Finnish.22 N'ihi ọnụ ọgụgụ dị ukwuu nke ịhapụ ụlọ akwụkwọ na ọnụ ahịa ịkpa oke dị ala (Ntinye mgbakwunye S1, 96% nke ndị nne na-agbaso ụkpụrụ ICVH), ewezuga mmega ahụ nke ime ime na ndị inyom dina.A na-ekewa ICVH n'ụzọ doro anya na ụdị ndị a: obere (ụmụ 0-3, nne 0-2), ọkara (ụmụ 4, nne 3-4) na elu (ụmụaka na ndị nne 5-6), na-enye ohere iji tụnyere ụdị dị iche iche. .
Jiri ngwa eletrọnịkị (Seca GmbH & Co. KG, Germany) tụọ ịdị elu na ịdị arọ na 0.1 cm kacha nso na 0.1 n'arọ.A na-emepụta akara BMI Z ụmụaka site na nhazi data ndị Finnish kacha ọhụrụ.Ngwakọta ahụ 22 gafere ntule impedance bioelectrical (InBody 720, InBody Bldg, South Korea).
A tụrụ ọbara mgbali elu izu ike site na usoro oscillometric site na ogwe aka nri n'ọnọdụ oche (Omron M6W, Omron Healthcare Europe BV, Netherlands) nwere akwa akwa zuru oke.A na-agbakọ nkezi systolic na ọbara mgbali elu diastolic site na nha abụọ kacha ala (opekempe nke nha atọ).A na-agbakọ uru ọbara mgbali elu ụmụaka Z dịka ntuziaka siri dị.25
A na-anakọta ihe nlele ọbara nke glucose plasma na lipids n'okpuru ọnọdụ ibu ọnụ.Nsonaazụ sitere na ụmụaka 3 nwere nnabata ọnụ na-ejighị n'aka (oke triglycerides dị elu, glucose ọbara na-ebu ọnụ, na haemoglobin glycosylated A1c (HbA1c)) ka ewepụrụ na nyocha ahụ.A na-ekpebi mkpokọta cholesterol, lipoprotein dị ala (LDL), cholesterol dị elu (HDL) na triglycerides site na usoro enzymatic, glucose plasma na mkpebi hexokinase enzymatic, na HbA1c na immunoturbidimetric analyzer (Roche Diagnostics, Basel, Switzerland) maka nyocha. .
A na-enyocha ihe oriri nke nne site na ajụjụ ajụjụ ugboro nri wee tụlekwuo ya site na ntụnye nri dị mma.A kwadoro Index Index nri ahụike na mbụ dị ka ngwa bara uru iji gosipụta nrube isi na Nkwanye Nutrition Nordic Nutrition 26 na otu RADIEL mbụ.24 Na nkenke, ọ nwere ihe iri na otu, na-ekpuchi oriri nke akwụkwọ nri, mkpụrụ osisi na mkpụrụ osisi, ọka ndị nwere fiber, azụ, mmiri ara ehi, cheese, mmanụ esi nri, nri abụba, nri nri, ihe ọṅụṅụ na-esi ísì ụtọ na nri ngwa ngwa.Ọnụ ọgụgụ dị elu na-egosipụta ọkwa dị elu nke nrube isi na ndụmọdụ ndị a.A na-enyocha ogo nri ụmụaka site na ndekọ nri ụbọchị 3 wee nyochaakwa ya site na Index nri nri ahụike ụmụaka nke Finnish.Edemedela ndepụta nri nri ahụike ụmụaka Finnish na mbụ n'ime ọnụ ọgụgụ ụmụaka Finnish.23 Ọ na-agụnye ụdị nri ise: akwụkwọ nri, mkpụrụ osisi na beri;mmanụ na margarine;nri nwere shuga;azụ na azụ na akwụkwọ nri;na mmiri ara ehi amịpụrụ.A na-eri nri nri nke mere na ọnụ ọgụgụ dị elu, nke dị elu.Ewezuga nri nwere nnukwu shuga, akara a na-atụgharị.Tupu ị nweta akara, gbanwee oriri ike site n'ikewa oriri (gram) site na oriri ume (kcal).Ka akara ahụ dị elu, ka mma nri ụmụaka dị mma.
A na-atụ ihe na-agafe agafe ruo ike siri ike (MVPA) site na iji ngwa ngwa osooso nwa hip (ActiGraph GT3X, ActiGraph, Pensacola, USA) na ogwe aka nne (SenseWear ArmBand Pro 3).Enyere ntụziaka iyi ihe nleba anya n'oge ịmụrụ anya na oge ụra, mana ewepụrụ oge ụra na nyocha ahụ.Onye nleba anya nwa na-anakọta data na ọnụego nlele nke 30 Hz.A na-enyochakarị data ahụ, tụgharịa gaa na ọnụ ọgụgụ oge nke abụọ nke abụọ, wee nyochaa ya site na iji ebe mbelata Evenson (2008) (≥2296 cpm).27 Nne nleba anya na-anakọta ụkpụrụ MET n'ime oge 60 nke abụọ.A na-agbakọ MVPA ka uru MET karịrị 3. A na-akọwa nha dị irè dị ka ọ dịkarịa ala ụbọchị ọrụ 2 na izu ụka 1 (na-edekọ ma ọ dịkarịa ala 480 nkeji kwa ụbọchị) na 3 ụbọchị ọrụ na 1 izu ụka (na-edekọ ma ọ dịkarịa ala 720 nkeji kwa ụbọchị) maka nne.A na-agbakọ oge MVPA dị ka nkezi dị arọ [(nkezi MVPA nkeji/ụbọchị na ụbọchị izu × 5 + nkezi MVPA nkeji/ụbọchị na ngwụsị izu × 2)/7], na mgbakwunye, dị ka pasent nke ngụkọta oge eyi.A na-eji data mmega ahụ kachasị ọhụrụ nke ndị Finnish mee ihe dị ka ihe ntụnye aka.28
A na-eji akwụkwọ akụkọ ahụ nweta ozi gbasara ise siga nke nne, ọrịa na-adịghị ala ala, ọgwụ, na agụmakwụkwọ.
A na-akọwapụta data dị ka ọ pụtara ± SD, etiti (oke etiti) ma ọ bụ ọnụ (pasent).Nyochaa nkesa nkịtị nke mgbanwe niile na-aga n'ihu dabere na histogram na atụmatụ QQ nkịtị.
Nleba t ule nke onwe, Mann-Whitney U ule, otu ụzọ nyocha nke iche iche, Kruskal-Wallis, na chi-square ule ejiri mee ihe kwesịrị ekwesị maka otu ntụnyere (nne na nwa, nwa nwoke na nwa agbọghọ, ma ọ bụ obere na ọkara na elu ICVH). ).
Eji Pearson ma ọ bụ Spearman na-emekọ ihe ọnụ iji chọpụta njikọ dị n'etiti njirimara nwata na nne.
A na-eji ụdị regression multivariate linear iji guzobe ihe atụ nkọwa maka HDL cholesterol ụmụaka na carotid IMT.Nhọrọ mgbanwe na-adabere na mmekọrịta yana ikpe ụlọ ọgwụ ọkachamara, na-ezere multicollinearity dị ịrịba ama na ihe nlereanya ahụ, ma na-agụnye ihe ndị nwere ike ịgbagwoju anya.A na-enyocha multicollinearity site na iji variance inflation factor, na oke uru nke 1.9.A na-eji ọnụọgụ ọnụọgụ ọnụọgụ dị iche iche iji nyochaa mmekọrịta ahụ.
Edebere P ≤ 0.05 ọdụdụ abụọ ka ọ bụrụ ihe dị ịrịba ama, ma e wezụga na nyocha mmekọrịta nke ndị na-achọpụta carotid artery IMT na ụmụaka nwere P ≤ 0.01.
E gosipụtara njirimara ndị so na ya na Tebụl 1 na Tebụl mgbakwunye S3.Tụnyere ọnụ ọgụgụ ndị nrụtụ aka, akara BMI Z ụmụaka na akara BP Z mụbara.Ọrụ anyị gara aga kọrọ nkọwa zuru ezu banyere morphology arterial na ụmụaka.14 Naanị 15 (12%) ụmụaka na 5 (2.7%) ndị nne zutere ụkpụrụ ICVH niile (Ntinye mgbakwunye 2 na 3, Tebụl mgbakwunye S4-S6).
Akara IVCH nke nne na nwa ọhụrụ metụtara naanị ụmụ nwoke (ụmụ nwoke: rs=0.32, P=0.01; ụmụ agbọghọ: rs=-0.18, P=0.2).Mgbe a tụlere ya dị ka mgbanwe na-aga n'ihu, nyocha mmekọrịta nke nne-nwa na-enwe mmetụta dị ukwuu na nha nke lipids ọbara, HbA1C, oke ibu, ọbara mgbali elu, na ịdị mma nri (Ngbakwunye S4-S10).
A na-ejikọta LDL ụmụaka na nne, HDL na mkpokọta cholesterol (r=0.23, P=0.003; r=0.35, P<0.0001; r=0.24, P=0.003, Figure 1).Mgbe agbajichara site na okike nwata, njikọ dị n'etiti LDL nwata na nne yana mkpokọta cholesterol ka dị ịrịba ama naanị n'ime ụmụ nwoke (Table S7).A na-ejikọta Triglycerides na HDL cholesterol na pasent abụba anụ ahụ ụmụ agbọghọ (rs=0.34, P=0.004; r=-0.37, P=0.002, n'otu n'otu, Figure 1, S8 mgbakwunye okpokoro).
Ọgụgụ 1 Mmekọrịta dị n'etiti lipids ọbara nwa na nne.Gbasaa nkata nwere ahịrị nkwụghachi azụ (95% nkeji oge ntụkwasị obi);(AC) ọkwa lipid ọbara nke nne na nwa ọhụrụ;(D) Pasent abụba anụ ahụ nwa agbọghọ na cholesterol dị elu nke lipoprotein.E gosipụtara nsonaazụ ndị dị mkpa na nkwuwa okwu (P ≤ 0.05).
Mbiri: LDL, lipoprotein dị obere;HDL, lipoproteins dị elu;r, Pearson njikọ ọnụ ọgụgụ.
Anyị chọpụtara na enwere mmekọrịta dị ịrịba ama n'etiti HbA1C nke nwatakịrị na nne (r=0.27, P=0.004), mana ọ nweghị ihe jikọrọ ya na glucose ọbara na-ebu ọnụ (P=0.4).Akara BMI Z ụmụaka, ma ọ bụghị pasentị abụba anụ ahụ, na-ejikọta ya na BMI nke nne na n'úkwù-na-hip (r=0.17, P=0.02; r=0.18, P=0.02, n'otu n'otu).Uru Z nke ọbara mgbali diastolic ụmụaka na-ejikọtaghị nke ọma na ọbara mgbali diastolic nke nne (r=0.15, P=0.03).A na-ejikọta ndepụta nri ahụike ụmụaka Finnish na ntinye nri nri ahụike nne (r=0.22, P 0.002).A hụrụ mmekọrịta a naanị na ụmụ nwoke (r=0.31, P=0.001).
Mgbe ewepụrụ ndị nne na-agwọ ọbara mgbali elu, hypercholesterolemia, ma ọ bụ hyperglycemia, nsonaazụ ya na-agbanwe agbanwe.
E gosipụtara phenotype arterial zuru ezu na tebụl mgbakwunye S9.Ọdịdị vaskụla nke ụmụaka na-adabereghị na njirimara ụmụaka (Okwu mgbakwunye S10).Anyị ahụghị njikọ ọ bụla n'etiti IPVH nwata na nhazi ma ọ bụ ọrụ vaskụla.N'ime nyocha nke ụmụntakịrị site na akara IMVH, anyị hụrụ na ọnụ ọgụgụ carotid IMT Z nke ụmụaka nwere naanị ọnụ ọgụgụ dị ala na-abawanye ma e jiri ya tụnyere ụmụaka nwere akara dị ala (pụtara ± SD; akara dị ala 0.41 ± 0.63 vs akara dị ala- 0.07 ± 0.71, P = 0.03, okpokoro mgbakwunye S11).
IPVH nke nne adịghị ejikọta ya na vaskụla phenotype ụmụaka (Tables S10 na S12).Ụmụaka na nne carotid artery IMT na-ejikọta ya (Nyocha 2), ma njikọ nne na nwa n'etiti ihe dị iche iche siri ike vaskụla abụghị ihe dị ịrịba ama (Table 9, Mgbakwunye S11).N'ụdị nkọwa ntụgharị mgbanwe dị iche iche emeziri maka okike ụmụaka, afọ, ọbara mgbali systolic, oke anụ ahụ, na pasent abụba anụ ahụ, carotid IMT nne bụ naanị amụma nọọrọ onwe ya nke carotid IMT ụmụaka (gbanwere R2 = 0.08).Maka 1 mm ọ bụla na-abawanye na carotid nne nne IMT, carotid nwata IMT mụbara site na 0.1 mm (95% CI 0.05, 0.21, P = 0.001) (Nkwupụta S13).Ụdị okike nke nwatakịrị ahụ ebelataghị mmetụta a.
Ọgụgụ 2 Mmekọrịta dị n'etiti akwara carotid intima-media ọkpụrụkpụ n'ime ụmụaka na ndị nne.Gbasaa nkata nwere ahịrị nkwụghachi azụ (95% nkeji oge ntụkwasị obi);(A) nne na nwa carotid IMT, (B) carotid nke nne IMT percentile na nwa carotid IMT z-akara.E gosipụtara nsonaazụ ndị dị mkpa na nkwuwa okwu (P ≤ 0.05).
A na-ejikọta akara arịa ọbara nke nne na ọnụọgụ mgbasawanye nke carotid na β stiffness index na ụmụaka (rs=-0.21, P=0.007, rs=0.16, P=0.04, S10 na-agbakwunye, n'otu n'otu).Ụmụaka ndị nne mụrụ nwere akara vaskụla nke 1-3 nwere ọnụ ọgụgụ dị ala nke mgbasawanye akwara carotid karịa ndị nne mụrụ na akara nke 0 (pụtara ± ọkọlọtọ ọkọlọtọ, 1.1 ± 0.2 vs 1.2 ± 0.2%/10 mmHg, P= 0.01) na enwere ike ịbawanye akwara carotid β stiffness index (median (IQR), 3.0 (0.7) na 2.8 (0.7), P = 0.052) na carotid artery IMT (pụtara ± SD, 0.37 ± 0.04 na 0.304 ± 0.35 ± mm, P=0.06) (Nyocha 3), okpokoro mgbakwunye S14).
Ọgụgụ 3 phenotype ụmụaka vaskụla nke ejiri akara akwara nne.A na-akọwapụta data dị ka ihe pụtara + SD, P na nnwale nnwere onwe t (A na C) yana ule Mann-Whitney U (B).E gosipụtara nsonaazụ ndị dị mkpa na nkwuwa okwu (P ≤ 0.05).Akara arịa ọbara nke nne: nso 0-3, setịpụrụ ihe ngosi ọnụọgụ atọ: ọnụnọ carotid plaque, ọkpụrụkpụ nke akwara carotid intima-media gbanwere site na afọ wee gafere 90% na nlele anyị, yana ebili mmiri cervical-femoral pulse. ọsọ gafere 90% bụ nke dabara na afọ yana ezigbo ọbara mgbali.iri abụọ na otu
Akara nne (ICVH, vaskụla vaskụla) na nchikota nke nwa na nke nne anaghị ejikọta ya na phenotype ụmụaka (Ntinye mgbakwunye S10).
Na nyocha nke akụkụ a nke ndị nne na ụmụ ha dị afọ 6, anyị nyochara njikọ dị n'etiti ICVH nwata, nne ICVH, na nne subclinical atherosclerosis na nhazi na ọrụ nke akwara ụmụaka.Isi nchoputa bụ na ọ bụ naanị nne subclinical atherosclerosis, mgbe ụmụaka na nne ot ọrịa obi ihe ize ndụ na-adịghị metụtara oghom mgbanwe na nwata vaskụla phenotypes.Nghọta ọhụrụ a banyere mmepe vaskụla nwata na-abawanye nghọta anyị banyere mmetụta intergenerational nke subclinical atherosclerosis.
Anyị na-akọ ihe àmà nke mbelata carotid artery dilatation na ọnọdụ na carotid artery beta stiffness na carotid artery IMT n'ime ụmụaka ndị nne nwere ọrịa obi na-arịa ọrịa obi.Otú ọ dị, ọ dịghị njikọ kpọmkwem n'etiti ihe ngosi ọrụ vaskụla nne na nwa.Anyị na-eche na itinye ihe ncheta nne n'ime akara akwara na-abawanye uru amụma ya nke ukwuu.
Anyị ahụwo mmekọrịta dị mma n'etiti carotid artery IMT na ụmụaka na ndị nne;Otú ọ dị, usoro ahụ ka edoghị anya n'ihi na carotid artery IMT na ụmụaka na-adabere na njirimara nke nwatakịrị na nne.Njikọ dị n'etiti akara ICVH ụmụaka na carotid IMT gosipụtara enweghị nkwekọrịta, n'ihi na anyị ahụghị ihe ọ bụla dị iche n'etiti IVH dị ala na elu ICVH.
Anyị maara na ihe ndị ọzọ nwere ike ịrụ ọrụ, gụnyere gburugburu isi ụmụaka, nke nwere ike bụrụ ihe dị mkpa na-ebu amụma maka ogo carotid artery n'oge mmalite nke uto.Na mgbakwunye, nsonaazụ anyị nwere ike ịpụta na ihe ndị na-enweghị atụ nke na-emetụta mmepe vaskụla nwa ebu n'afọ.Otú ọ dị, anyị ekwuola na mbụ ịtụrụ ime ibu oke / oke ibu na ọrịa shuga gestation enweghị mmetụta na nwata carotid IMT.14 Nchọpụta ọzọ dị mkpa iji chọpụta mmetụta nke nhazi akwara na ọrụ na uto ụmụaka na mkpụrụ ndụ ihe nketa.
Mkpakọrịta ndị a kọrọ na-adabere na ọmụmụ ihe ndị gara aga e mere na ndị nọ n'afọ iri na ụma, bụ ndị na-enye ihe àmà nke mkpakọrịta n'etiti nne na nna na ụmụaka vaskụla phenotypes, gụnyere carotid IMT, ọ bụ ezie na a naghị edozi nha ahụ na nyocha.29 Ihe nketa dị ukwuu nke carotid IMT na-akwado nke a na isi akwara ndị okenye.30,31
Mmekọrịta a hụrụ n'etiti atherosclerosis subclinical nne na nwa vaskụla phenotype agbasaghị site na nne ICVH.Nke a kwekọrọ na ọmụmụ ihe gara aga nke a na-akọwa akụkụ dị ukwuu nke mgbanwe dị na phenotype ụmụaka site na mkpụrụ ndụ ihe nketa na-adabere na ihe ize ndụ obi obi nke ndị nne na nna na ụmụaka.29
Tụkwasị na nke ahụ, mgbanwe vaskụla a na-ahụ anya enweghị ihe jikọrọ ya na ICVH nwata, na-egosi mmetụta bụ isi nke mkpụrụ ndụ ihe nketa nwata.Ntinye aka nke ihe gbasara gburugburu ebe obibi yiri ka ọ na-agbanwe na afọ ụmụaka, dịka ọmụmụ ihe ọmụmụ buru ibu na-agafe na mbụ nke ụmụaka dị afọ 11-12 kọrọ njikọ dị ịrịba ama n'etiti ọrụ vaskụla ụmụaka na IVCH.12