Background

Patients with cystic fibrosis (CF) are exposed to overlapping cardiovascular risk factors. We hypothesized that CF is characterized by increased arterial stiffness and greater intima-media thickness (IMT).

Methods

This cross-sectional study assessed the digital volume pulse arterial stiffness index (SI_DVP) using photopletysmography, measured intima-media complex thickness (IMT) at the common carotid artery, and obtained an extended set of clinical and atherosclerosis-related laboratory parameters.

Results

Fifty-five patients with moderate-to-severe CF (mean age 26.3±8.6 years, BMI 20.3±3.1 kg/m2, FEV1 62±26%) and 51 healthy controls (25.1±4.4 years, BMI 21.7±3.0 kg/m2) entered the study. SI_DVP was greater in pancreatic insufficient (PI), but not pancreatic sufficient (PS) CF patients compared with control (7.3±1.8 m/s vs 6.0±1.2 m/s; p=7.1 × 10⁻⁵). IMT was increased in PS (but not PI) participants relative to control (552±69 µm vs 456±95 µm, p=0.0011). SI_DVP was also greater in PI than in PS patients (7.3±1.8 m/s vs 6.3±1.7 m/s, p=0.0232) and IMT was higher in PS compared with PI (552±69 µm vs 453±82 µm, p=0.0002). SI_DVP independently associated with age, PI, the lack of liver cirrhosis, and with Pseudomonas aeruginosa colonization. PS was the only independent correlate of IMT in CF.

Conclusions

PI patients are at risk of developing general arterial stiffness. PS may relate to carotid IMT thickening, which underscores the need for further study that could lead to reconsideration of dietary guidance in PS CF.

中文翻译：

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囊性纤维化中的临床前动脉粥样硬化：两种不同的表现与胰腺状态有关

背景

囊性纤维化 (CF) 患者暴露于重叠的心血管危险因素。我们假设 CF 的特征是动脉僵硬度增加和内膜中层厚度 (IMT) 增加。

方法

这项横断面研究使用光电容积描记法评估了数字容积脉搏动脉僵硬度指数 (SI _DVP )，测量了颈总动脉的内膜中层复合体厚度 (IMT)，并获得了一组扩展的临床和动脉粥样硬化相关实验室参数。

结果

55 名中重度 CF 患者（平均年龄 26.3±8.6 岁，BMI 20.3±3.1 kg/m2，FEV1 62±26%）和 51 名健康对照者（25.1±4.4 岁，BMI 21.7±3.0 kg/m2 ) 进入研究。与对照组相比，胰腺功能不足 (PI) 但胰腺功能不足 (PS) CF 患者的SI _{DVP更大（7.3±1.8 m/s 对比 6.0±1.2 m/s；p=7.1 × 10} ^-5）。与对照组相比，PS（但不是 PI）参与者的 IMT 增加（552±69 µm 对 456±95 µm，p=0.0011）。PI 患者的SI _DVP也高于 PS 患者（7.3±1.8 m/s vs 6.3±1.7 m/s，p=0.0232），PS 患者的 IMT 高于 PI（552±69 µm vs 453±82 µm， p = 0.0002)。SI _DVP与年龄、PI、肝硬化缺乏和铜绿假单胞菌独立相关殖民化。PS 是 CF 中 IMT 的唯一独立相关因素。

结论

PI 患者有发生全身动脉僵硬的风险。PS 可能与颈动脉 IMT 增厚有关，这强调了进一步研究的必要性，这可能导致重新考虑 PS CF 的饮食指导。