Department of Pediatrics, University Hospital of Ioannina, Ioannina, Greece.
Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece.
J Clin Lipidol. 2021 Mar-Apr;15(2):292-300. doi: 10.1016/j.jacl.2020.12.003. Epub 2020 Dec 11.
Dyslipidemia has been associated with endothelial dysfunction in childhood. Impairment of renal function has been demonstrated in dyslipidemic adults.
The aim of this study was to assess markers of early endothelial and renal dysfunction in dyslipidemic children.
This was a cross-sectional study of 100 children with dyslipidemia and 100 age- and sex-matched control subjects without dyslipidemia aged 7-16 years. Renal dysfunction was assessed by measurement of serum creatinine and cystatin C levels, urinary beta 2-microglobulin levels, urinary albumin to creatinine (Alb:Cr) ratio, and by the estimated glomerular filtration rate (eGFR), based on serum creatinine or cystatin C. Endothelial dysfunction and early vascular changes were evaluated by ultrasound assessment of flow mediated dilation (FMD) of the brachial artery, and carotid intima-media thickness (cIMT), respectively.
The markers of early renal dysfunction showed no difference between the dyslipidemic children and control subjects except for the urinary Alb:Cr ratio that was higher in the dyslipidemic children (median, 0.007 mg/mg vs 0.005 mg/mg, p = 0.004). The urinary Alb:Cr ratio was positively correlated with the triglyceride to high-density lipoprotein cholesterol ratio (r = 0.28, p = 0.013). FMD values were lower in the dyslipidemic children than in the control subjects (8.504 ± 4.73% vs 10.535 ± 4.35%, p = 0.004), but cIMT did not differ between groups. This decrease in FMD values was evident in children aged ≥10 years. FMD was independently associated with the level of lipoprotein (a) (beta = -0.29, p = 0.01).
Among markers of endothelial and renal dysfunction investigated, FMD was found to be lower and the urinary Alb:Cr ratio higher in children with dyslipidemia.
血脂异常与儿童期内皮功能障碍有关。血脂异常的成年人已被证明存在肾功能损害。
本研究旨在评估血脂异常儿童早期内皮和肾功能障碍的标志物。
这是一项横断面研究，纳入了 100 名血脂异常儿童和 100 名年龄和性别匹配的无血脂异常儿童，年龄为 7-16 岁。通过测量血清肌酐和胱抑素 C 水平、尿β2-微球蛋白水平、尿白蛋白与肌酐（Alb：Cr）比值以及基于血清肌酐或胱抑素 C 的估计肾小球滤过率（eGFR）评估肾功能障碍。通过肱动脉血流介导的扩张（FMD）和颈动脉内膜中层厚度（cIMT）评估内皮功能障碍和早期血管变化。
除了血脂异常儿童的尿 Alb：Cr 比值较高（中位数，0.007 mg/mg 比 0.005 mg/mg，p = 0.004）外，血脂异常儿童与对照组的早期肾功能障碍标志物无差异。尿 Alb：Cr 比值与甘油三酯与高密度脂蛋白胆固醇比值呈正相关（r = 0.28，p = 0.013）。FMD 值在血脂异常儿童中低于对照组（8.504 ± 4.73%比 10.535 ± 4.35%，p = 0.004），但两组间 cIMT 无差异。这种 FMD 值的降低在年龄≥10 岁的儿童中更为明显。FMD 与脂蛋白（a）水平独立相关（β = -0.29，p = 0.01）。
在所研究的内皮和肾功能障碍标志物中，血脂异常儿童的 FMD 较低，尿 Alb：Cr 比值较高。
