有早发性心血管疾病家族史的儿童及其父母动脉粥样硬化的选定风险因素：一项前瞻性研究。

Selected risk factors for atherosclerosis in children and their parents with positive family history of premature cardiovascular diseases: a prospective study.

作者信息

Pac-Kozuchowska Elzbieta, Krawiec Paulina, Grywalska Ewelina

机构信息

Department of Paediatrics and Gastroenterology, Medical University of Lublin, Gebali 6 Street, 20-093, Lublin, Poland.

Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, Chodzki 4a Street, 20-093, Lublin, Poland.

出版信息

BMC Pediatr. 2018 Apr 3;18(1):123. doi: 10.1186/s12887-018-1102-2.

DOI:10.1186/s12887-018-1102-2

PMID:29615006

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5883418/

Abstract

BACKGROUND

The aim of the study was to evaluate serum parameters of lipid metabolism, homocysteine, soluble adhesion molecules and common carotid artery wall thickness in children from families with early symptoms of atherosclerosis.

METHODS

The first stage included 137 pairs of mothers and newborns, and the second 18 children from the same group (age 18-30 months) and their parents (age 21-46 years) with a history of premature coronary artery disease (CAD), as well as 12 age- and sex-matched controls.

RESULTS

During the first stage, inverse correlations were found between birthweight, cord blood concentrations of triglycerides (TG), VLDL cholesterol and apolipoprotein B (Apo B). Serum concentrations of total cholesterol (TC), apolipoprotein A1 (Apo A1), LDL and HDL cholesterol and were significantly higher in female than in male newborns. During the second stage, children from families with a history for premature CAD were shown to present with significantly higher serum concentrations of TG, VLDL cholesterol and lipoprotein A (Lp(a)) than the controls. Furthermore, their TC correlated positively with vascular cell adhesion molecule-1 (Rs=0.717, p<0.05) and intracellular adhesion molecule-1 (sICAM-1) levels (Rs=0.833, p<0.05). Moreover, positive correlations were found between maternal carotid intima media thickness (IMT) and TC (Rs=0.831, p<0.01), as well as between paternal IMT and Apo B (Rs=0.692, p<0.05), TG and sICAM-1 (Rs=0.912, p<0.01), TG and sE-selectin (Rs=0.678, p<0.05).

CONCLUSIONS

Serum Lp(a) may serve as a maker of cardiovascular risk in children and adolescents.

摘要

背景

本研究旨在评估动脉粥样硬化早期症状家庭中儿童的脂质代谢血清参数、同型半胱氨酸、可溶性黏附分子和颈总动脉壁厚度。

方法

第一阶段纳入137对母婴，第二阶段纳入来自同一组的18名儿童（年龄18 - 30个月）及其父母（年龄21 - 46岁），这些儿童有早发冠心病（CAD）病史，以及12名年龄和性别匹配的对照。

结果

在第一阶段，出生体重与脐带血甘油三酯（TG）、极低密度脂蛋白胆固醇和载脂蛋白B（Apo B）浓度呈负相关。女性新生儿的总胆固醇（TC）、载脂蛋白A1（Apo A1）、低密度脂蛋白和高密度脂蛋白胆固醇血清浓度显著高于男性新生儿。在第二阶段，有早发CAD病史家庭的儿童血清TG、极低密度脂蛋白胆固醇和脂蛋白A（Lp(a)）浓度显著高于对照组。此外，他们的TC与血管细胞黏附分子 - 1（Rs = 0.717，p < 0.05）和细胞间黏附分子 - 1（sICAM - 1）水平呈正相关（Rs = 0.833，p < 0.05）。此外，母亲颈动脉内膜中层厚度（IMT）与TC之间呈正相关（Rs = 0.831，p < 0.01），父亲IMT与Apo B之间呈正相关（Rs = 0.692，p < 0.05），TG与sICAM - 1之间呈正相关（Rs = 0.912，p < 0.01），TG与sE - 选择素之间呈正相关（Rs = 0.678，p < 0.05）。