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患有威廉姆斯-贝伦综合征的儿童和青少年心血管危险因素的高患病率。

High prevalence of cardiovascular risk factors in children and adolescents with Williams-Beuren syndrome.

作者信息

Takeuchi Daiji, Furutani Michiko, Harada Yuriko, Furutani Yoshiyuki, Inai Kei, Nakanishi Toshio, Matsuoka Rumiko

机构信息

Department of Pediatric Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

The International Research and Educational Institute for Integrated Medical Sciences (IREIIMS), Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

出版信息

BMC Pediatr. 2015 Sep 17;15:126. doi: 10.1186/s12887-015-0445-1.

Abstract

BACKGROUND

A high incidence of cardiovascular (CV) risk factors has been reported in adults with Williams-Beuren syndrome (WS). However, the prevalence of these factors in children and adolescents with WS is unknown. Therefore, the purpose of this study was to evaluate the prevalence of CV risk factors in these patients.

METHODS

Thirty-two WS patients aged <18 years were enrolled in the study. Oxidized low-density lipoprotein levels (n = 32), oral glucose tolerance test results (n = 20), plasma renin and aldosterone levels (n = 31), 24-h ambulatory blood pressure (ABP; n = 24), carotid artery intima-media thickness (IMT; n = 15), and brachial artery flow-mediated dilatation (FMD; n = 15) were measured and analyzed.

RESULTS

The lipid profile revealed hypercholesterolemia in 22% and elevated oxidized low-density lipoprotein levels in 94% of the patients. Glucose metabolism abnormalities were found in 70% of the patients. Insulin resistance was observed in 40% of the patients. High plasma renin and aldosterone levels were detected in 45 and 39% of the patients, respectively. A mean systolic blood pressure above the 90th percentile was noted in 29% of patients. High IMT (>0.65 mm) and low FMD (<9%) were detected in 80 and 73% of patients, respectively.

CONCLUSION

In patients with WS, CV risk factors are frequently present from childhood. In children with WS, screening tests for the early detection of CV risk factors and long-term follow-up are required to determine whether long-term exposure to these factors increases the risk for CV events in adulthood.

摘要

背景

有报道称威廉姆斯综合征(WS)成年患者心血管(CV)危险因素的发生率较高。然而,WS儿童和青少年中这些危险因素的患病率尚不清楚。因此,本研究的目的是评估这些患者中CV危险因素的患病率。

方法

32名年龄小于18岁的WS患者纳入本研究。测量并分析了氧化型低密度脂蛋白水平(n = 32)、口服葡萄糖耐量试验结果(n = 20)、血浆肾素和醛固酮水平(n = 31)、24小时动态血压(ABP;n = 24)、颈动脉内膜中层厚度(IMT;n = 15)和肱动脉血流介导的舒张功能(FMD;n = 15)。

结果

血脂谱显示,22%的患者存在高胆固醇血症,94%的患者氧化型低密度脂蛋白水平升高。70%的患者存在糖代谢异常。40%的患者观察到胰岛素抵抗。分别在45%和39%的患者中检测到高血浆肾素和醛固酮水平。29%的患者平均收缩压高于第90百分位数。分别在80%和73%的患者中检测到高IMT(>0.65 mm)和低FMD(<9%)。

结论

在WS患者中,CV危险因素在儿童期就经常存在。对于WS儿童,需要进行筛查试验以早期发现CV危险因素,并进行长期随访,以确定长期暴露于这些因素是否会增加成年期发生CV事件的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77d6/4574554/5071966ad1bb/12887_2015_445_Fig1_HTML.jpg

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