Joanna Tołwińska, Artur Bossowski, Jolanta Szczepańska-Kostro, Barbara Głowińska, Mirosława Urban
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Because of localization, brachial and carotid arteries are a very good field for this kind of examinations.</p><p><strong>Objectives: </strong>Evaluation with high resolution echocardiography, selected parameters of endothelial function in children with growth hormone deficiency before replacement therapy. We measured the intimal plus medial thickness in carotid communis arteries (IMT) also.</p><p><strong>Material and methods: </strong>We examined a group of 24 children (19 boys and 5 girls) aged 8-16 yr (mean 12 yr) suffered from growth hormone (GH) deficiency. The control group consisted of 24 children in similar age and sex relation. Using high resolution echocardiography, B-mode images, we measured in end diastole, distance \"m-m\" in brachial arteries (distance between two \"m\" lines which are borders among media and adventitia of near and far wall of the artery) at rest, during reactive hyperaemia (with increased flow causing endothelium-dependent dilatation FMD), again at rest and after sublingual glyceryl trinitrate (causing endothelium-independent dilatation NTGMD). Using Doppler technique we evaluated baseline flow and calculated degree of reactive hyperemia. We also measured intimal plus medial thickness in every carotid artery three times and calculated mean value. In our analysis we estimated concentrations of cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides.</p><p><strong>Results: </strong>In children with growth hormone deficiency the vessel size was smaller then in the control group and FMD was significantly impaired (10.05% v. 14.62%; p=0.058). NTGMD was similar to the control group (p=0.,371). We noticed higher IMT values in the whole examined group compared to the control group (0.52 mm v. 0.41 mm; p=0.0000). We noticed an important correlation between FMD and IMT in whole patients (examined plus control group) (p=0.004). The level of total cholesterol was higher in the examined group (p=0.039).</p><p><strong>Conclusions: </strong>1. FMD evaluated in brachial artery, seems to be an useful sign of impaired endothelial function in children suffering from the risk factors of atherosclerosis. 2. The evaluation of IMT in carotid arteries in patients with growth hormone deficiency showed a more advanced degree of atherosclerotic changes in this group compared to healthy controls. 3. Ultrasonographic evaluation of premature atherosclerosis in children with growth hormone deficiency is a basis for the future estimation of positive effects of the replacement therapy.</p>","PeriodicalId":11550,"journal":{"name":"Endokrynologia, diabetologia i choroby przemiany materii wieku rozwojowego : organ Polskiego Towarzystwa Endokrynologow Dzieciecych","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Ultrasonographic evaluation of atherosclerotic changes in carotid and brachial arteries in children with growth hormone deficiency before GH replacement therapy].\",\"authors\":\"Joanna Tołwińska, Artur Bossowski, Jolanta Szczepańska-Kostro, Barbara Głowińska, Mirosława Urban\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>According to very well documented onset of atherosclerosis in early childhood, scientists are looking for good diagnostic methods for evaluating first changes in arterial blood vessels non-invasively. We want to know more about pathogenetic mechanisms and about changes in vessels especially in the group of young people with risk factors of premature atherosclerosis. The role of endothelial dysfunction in the very early phase of this process is known very well so far. High resolution echocardiography seems to be a good method which allows to examine arteries in children and adolescents. Because of localization, brachial and carotid arteries are a very good field for this kind of examinations.</p><p><strong>Objectives: </strong>Evaluation with high resolution echocardiography, selected parameters of endothelial function in children with growth hormone deficiency before replacement therapy. We measured the intimal plus medial thickness in carotid communis arteries (IMT) also.</p><p><strong>Material and methods: </strong>We examined a group of 24 children (19 boys and 5 girls) aged 8-16 yr (mean 12 yr) suffered from growth hormone (GH) deficiency. The control group consisted of 24 children in similar age and sex relation. Using high resolution echocardiography, B-mode images, we measured in end diastole, distance \\\"m-m\\\" in brachial arteries (distance between two \\\"m\\\" lines which are borders among media and adventitia of near and far wall of the artery) at rest, during reactive hyperaemia (with increased flow causing endothelium-dependent dilatation FMD), again at rest and after sublingual glyceryl trinitrate (causing endothelium-independent dilatation NTGMD). Using Doppler technique we evaluated baseline flow and calculated degree of reactive hyperemia. We also measured intimal plus medial thickness in every carotid artery three times and calculated mean value. In our analysis we estimated concentrations of cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides.</p><p><strong>Results: </strong>In children with growth hormone deficiency the vessel size was smaller then in the control group and FMD was significantly impaired (10.05% v. 14.62%; p=0.058). NTGMD was similar to the control group (p=0.,371). We noticed higher IMT values in the whole examined group compared to the control group (0.52 mm v. 0.41 mm; p=0.0000). We noticed an important correlation between FMD and IMT in whole patients (examined plus control group) (p=0.004). The level of total cholesterol was higher in the examined group (p=0.039).</p><p><strong>Conclusions: </strong>1. FMD evaluated in brachial artery, seems to be an useful sign of impaired endothelial function in children suffering from the risk factors of atherosclerosis. 2. The evaluation of IMT in carotid arteries in patients with growth hormone deficiency showed a more advanced degree of atherosclerotic changes in this group compared to healthy controls. 3. 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引用次数: 0
摘要
背景:根据对儿童早期动脉粥样硬化发病的详细记录,科学家们正在寻找良好的诊断方法来评估动脉血管的首次无创变化。我们想知道更多关于发病机制和血管的变化,特别是在有过早动脉粥样硬化危险因素的年轻人群体中。到目前为止,内皮功能障碍在这一过程的早期阶段所起的作用是非常清楚的。高分辨率超声心动图似乎是一个很好的方法,允许检查动脉在儿童和青少年。由于定位,臂动脉和颈动脉是很好的检查领域。目的:用高分辨率超声心动图评价生长激素缺乏症患儿替代治疗前内皮功能的选择参数。我们还测量了颈动脉社区动脉(IMT)的内膜和内侧厚度。材料和方法:我们研究了一组24名8-16岁(平均12岁)的生长激素(GH)缺乏症儿童(男孩19名,女孩5名)。对照组为24例年龄、性别相近的儿童。使用高分辨率超声心动图,b型图像,我们测量了舒张末期,静止时肱动脉的距离“m-m”(两条“m”线之间的距离,这两条线是动脉近壁和远壁的中膜和外膜之间的边界),反应性充血期间(流量增加导致内皮依赖性扩张FMD),再次静止时和舌下三硝酸甘油(导致内皮依赖性扩张NTGMD)。采用多普勒技术评估基线血流并计算反应性充血程度。我们还测量了每条颈动脉的内膜和内侧厚度三次,并计算了平均值。在我们的分析中,我们估计了胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯的浓度。结果:生长激素缺乏患儿血管尺寸小于对照组,FMD明显受损(10.05% vs . 14.62%;p = 0.058)。NTGMD与对照组相似(p= 0,371)。我们注意到,与对照组相比,整个检查组的IMT值更高(0.52 mm vs 0.41 mm;p = 0.0000)。我们注意到整个患者(检查组和对照组)FMD和IMT之间存在重要的相关性(p=0.004)。检查组总胆固醇水平较高(p=0.039)。结论:1。肱动脉FMD的评估,似乎是患有动脉粥样硬化危险因素的儿童内皮功能受损的有用标志。2. 生长激素缺乏症患者颈动脉IMT的评估显示,与健康对照组相比,该组患者的动脉粥样硬化改变程度更高。3.生长激素缺乏症儿童早期动脉粥样硬化的超声评价是未来评估替代治疗积极作用的基础。
[Ultrasonographic evaluation of atherosclerotic changes in carotid and brachial arteries in children with growth hormone deficiency before GH replacement therapy].
Background: According to very well documented onset of atherosclerosis in early childhood, scientists are looking for good diagnostic methods for evaluating first changes in arterial blood vessels non-invasively. We want to know more about pathogenetic mechanisms and about changes in vessels especially in the group of young people with risk factors of premature atherosclerosis. The role of endothelial dysfunction in the very early phase of this process is known very well so far. High resolution echocardiography seems to be a good method which allows to examine arteries in children and adolescents. Because of localization, brachial and carotid arteries are a very good field for this kind of examinations.
Objectives: Evaluation with high resolution echocardiography, selected parameters of endothelial function in children with growth hormone deficiency before replacement therapy. We measured the intimal plus medial thickness in carotid communis arteries (IMT) also.
Material and methods: We examined a group of 24 children (19 boys and 5 girls) aged 8-16 yr (mean 12 yr) suffered from growth hormone (GH) deficiency. The control group consisted of 24 children in similar age and sex relation. Using high resolution echocardiography, B-mode images, we measured in end diastole, distance "m-m" in brachial arteries (distance between two "m" lines which are borders among media and adventitia of near and far wall of the artery) at rest, during reactive hyperaemia (with increased flow causing endothelium-dependent dilatation FMD), again at rest and after sublingual glyceryl trinitrate (causing endothelium-independent dilatation NTGMD). Using Doppler technique we evaluated baseline flow and calculated degree of reactive hyperemia. We also measured intimal plus medial thickness in every carotid artery three times and calculated mean value. In our analysis we estimated concentrations of cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides.
Results: In children with growth hormone deficiency the vessel size was smaller then in the control group and FMD was significantly impaired (10.05% v. 14.62%; p=0.058). NTGMD was similar to the control group (p=0.,371). We noticed higher IMT values in the whole examined group compared to the control group (0.52 mm v. 0.41 mm; p=0.0000). We noticed an important correlation between FMD and IMT in whole patients (examined plus control group) (p=0.004). The level of total cholesterol was higher in the examined group (p=0.039).
Conclusions: 1. FMD evaluated in brachial artery, seems to be an useful sign of impaired endothelial function in children suffering from the risk factors of atherosclerosis. 2. The evaluation of IMT in carotid arteries in patients with growth hormone deficiency showed a more advanced degree of atherosclerotic changes in this group compared to healthy controls. 3. Ultrasonographic evaluation of premature atherosclerosis in children with growth hormone deficiency is a basis for the future estimation of positive effects of the replacement therapy.