Elevated Serum C-Reactive Protein Levels and Early Arterial Changes in Healthy Children

M. Järvisalo, A. Harmoinen, Maarit Hakanen, U. Paakkunainen, J. Viikari, J. Hartiala, T. Lehtimäki, O. Simell, O. Raitakari
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引用次数: 331

Abstract

Objective—Elevated serum concentration of C-reactive protein (CRP) predicts cardiovascular events in adults. Because atherosclerosis begins in childhood, we undertook a study to determine whether changes in brachial artery endothelial function and the thickness of the carotid intima-media complex, 2 markers of early atherosclerosis, are related to CRP levels in healthy children. Methods and Results—Brachial artery flow-mediated dilatation (FMD) and carotid artery intima-media thickness (IMT) were measured with ultrasound in 79 children (aged 10.5±1.1 years). Compared with the children with CRP levels under the detection limit (<0.1 mg/L, n=40, group 1), the children with higher CRP (0.1 mg/L≤CRP≤0.7 mg/L, n=20, group 2; CRP >0.7 mg/L, n=19, group 3) had lower FMD (9.0±4.4% versus 7.8±3.3% versus 6.5±2.6%, respectively;P =0.015 for trend) and greater carotid IMT (0.45±0.03 versus 0.46±0.04 versus 0.49±0.06 mm, respectively, P =0.002 for trend). CRP level remained a statistically significant independent predictor for brachial FMD and carotid IMT in multivariate analyses. Conclusions—These data suggest that CRP affects the arteries of healthy children by disturbing endothelial function and promoting intima-media thickening. The findings support the hypothesis that CRP plays a role in the pathogenesis of early atherosclerosis.
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健康儿童血清c反应蛋白水平升高与早期动脉变化
目的:血清c反应蛋白(CRP)浓度升高可预测成人心血管事件。由于动脉粥样硬化始于儿童时期,我们进行了一项研究,以确定健康儿童的臂动脉内皮功能和颈动脉内膜-中膜复合体厚度的变化(早期动脉粥样硬化的两个标志)是否与CRP水平有关。方法与结果:对79例儿童(年龄10.5±1.1岁)的肱动脉血流介导扩张(FMD)和颈动脉内膜-中膜厚度(IMT)进行超声测量。与CRP水平低于检出限(0.7 mg/L, n=19,组3)的儿童相比,FMD较低(分别为9.0±4.4%对7.8±3.3%对6.5±2.6%,P =0.015趋势),颈动脉IMT较大(分别为0.45±0.03对0.46±0.04对0.49±0.06 mm, P =0.002趋势)。在多变量分析中,CRP水平仍然是具有统计学意义的肱FMD和颈动脉IMT的独立预测因子。结论:这些数据表明CRP通过干扰内皮功能和促进内膜-中膜增厚来影响健康儿童的动脉。这些发现支持了CRP在早期动脉粥样硬化发病机制中起作用的假设。
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