The Study Of Carotid Artery Elasticity And The Effect Of Serum Vitamin D Level On Arterial Elasticity In Obese Youth By Ultrafast Pulse Wave Velocity Technique

ObjectiveTo examine the elasticity of carotid arteries in obese young people using the ultrafast pulse wave velocity(UFPWV)technique and to study the effect of serum 25-hydroxyvitamin D [25(OH)D] level on changes in carotid artery elasticity,in order to provide information for the early prevention of atherosclerosis.MethodsYoung obese patients examined at our hospital between March 2019 and December 2020 were collected,those with carotid intimal medial(CIMT)thickening and unclear images were excluded after performing carotid ultrasound,and finally 80 obese young patients were included in this study as the study group.During the same period,50 healthy non-obese youths who attended the physical examination at the physical examination center were selected as the control group for this study.All enrolled individuals were divided into normal,overweight and obese groups according to body mass index(BMI),with 50,42 and 38 cases in each group.Clinical and laboratory indices were collected and CIMT were measured in all participants,and pulse wave propagation velocity at the beginning and end of carotid systole(PWVBS and PWVES)were determined by applying the UFPWV technique.Clinical parameters and carotid artery elasticity parameters were compared among three groups.According to vitamin D levels,the overweight and obese groups were divided into 25(OH)D non-deficient and 25(OH)D deficient subgroups,and the parameters between the two subgroups were compared.The correlation between PWVBS and PWVES and clinical indexes were analyzed,and then the factors affecting PWVBS and PWVES were explored.All data were analyzed using SPSS Statistics 22.0 software.P<0.05 was considered statistically significant.Results1.Comparison of PWVBS and PWVES on the left and right sides of three groupsThere were no significant difference between the left and right PWVBS and PWVES in the three groups(P<0.05).2.Comparison of PWVBS and PWVES between different gendersPWVBS and PWVES had no significant difference between different sexes(P<0.05).3.Comparison of clinical data and ultrasound parameters among normal group,overweight group and obese groupThere were no significant differences in sex,age,DBP,FBG and TG among the three groups(P>0.05).The differences of BMI,WC,SBP,LDL-C,HDL-C,TC,25(OH)D,PWVBS and PWVES among all groups were statistically significant(P<0.05).Comparing the IMT of all groups,it was found that the overweight or obese group was higher than the control group(P<0.05),while the difference in IMT between the overweight and obese groups was not statistically significant(P>0.05).4.Comparison of parameters between different 25(OH)D levels in overweight and obese groupsThe differences in HDL-C,IMT,PWVBS and PWVES between the two subgroups were statistically significant(P<0.05).5.Correlation analysis of PWVBS,PWVES and each index(1)BMI,SBP,LDL-C,TC,IMT were positively correlated with PWVBS,r=0.712,0.313,0.501,0.661,0.683(P<0.05),and HDL-C,25(OH)D were negatively correlated with PWVBS,r=-0.428,-0.632(P<0.05).(2)BMI,SBP,LDL-C,TC,IMT were positively correlated with PWVES,r=0.709,0.278,0.527,0.652,0.691(P<0.05),and negatively correlated with PWVES were 25(OH)D and HDL-C,r=-0.671,-0.658(P<0.05).6.Analysis of influencing factors of PWVBS and PWVES(1)The influencing factors of PWVBS were BMI,25(OH)D,IMT,the beta coefficients were 0.507,-0.176 and 0.368 respectively(P<0.05).(2)The influencing factors of PWVES were BMI,25(OH)D,HDL-C,IMT,the beta coefficients were 0.421,-0.258,-0.264 and 0.207 respectively(P<0.05).7.PWVBS,PWVES reference values(1)The critical value of PWVBS was >5.40 m/s,and the sensitivity and specificity were 67.5% and 88.0% respectively(P<0.05).(2)The critical value of PWVES was >6.70 m/s,and the sensitivity and specificity were 86.3% and 72.0% respectively(P<0.05).Conclusions1.Obesity can reduce the elasticity of arteries in young people,UFPWV technology can detect the change of carotid artery elasticity in obese young people at the early stage.2.Reduced serum 25(OH)D can exacerbate the impaired elasticity of carotid arteries in obese young people.3.Arterial elasticity index PWVBS and PWVES have a good correlation with the risk factors of arteriosclerosis,which can be used as a convenient index for clinical evaluation of arterial elasticity.