Bruzzi Patrizia, Predieri Barbara, Madeo Simona, Lami Francesca, Iughetti Lorenzo
1Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
Acta Biomed. 2021 Nov 3;92(5):e2021343. doi: 10.23750/abm.v92i5.11074.
Children with heterozygous familial hypercholesterolemia (heFH) are at risk of premature atherosclerosis. Aims of this study were: (a) to longitudinally evaluate the endothelial dysfunction, estimated through brachial flow mediated dilation (FMD), as first sign of subclinical atherogenesis in a group of children and adolescents affected by heFH in comparison to normo-lipidemic controls, and (b) to identify predictive factors influencing the endothelial function and its development in the same cohort of patients.
This is a prospective, longitudinal and cross-sectional study. Physical examination, plasma lipid profile and brachial artery FMD were measured at baseline and after follow-up.
At baseline, FMD did not differ between heFH children (n.24, median age 9.71) and controls (n. 24, median age 10.29) (7.67 ± 9.26 vs. 11.18 ± 7.28 %, p 0.09). Nevertheless, during follow-up (median length of lipid-lowering diet 4.52 years), FMD got worse in 54% of heFH subjects and its worsening correlated to the increasing of low-density lipoprotein cholesterol (r -0.21, p < 0.05). Moreover, being male (β -0.46, p 0.03), undergoing puberty (β -0.61, p 0.03) and increasing of body mass index standard deviation score (β -0.39, p 0.03) were identified as main independent predictor factors of FMD drop.
During the first decades of life, not only hypercholesterolemia, but also clusters of pro-atherogenic conditions and their persistence, could affect the endothelial function and its trend. (www.actabiomedica.it).
杂合子家族性高胆固醇血症（heFH）患儿有过早发生动脉粥样硬化的风险。本研究的目的是：（a）纵向评估通过肱动脉血流介导的血管舒张（FMD）估计的内皮功能障碍，作为一组heFH患儿和青少年亚临床动脉粥样硬化发生的首个迹象，并与血脂正常的对照组进行比较；（b）确定影响同一队列患者内皮功能及其发展的预测因素。
这是一项前瞻性、纵向和横断面研究。在基线和随访后进行体格检查、血浆脂质谱和肱动脉FMD测量。
在基线时，heFH患儿（n = 24，中位年龄9.71岁）和对照组（n = 24，中位年龄10.29岁）的FMD无差异（7.67±9.26%对11.18±7.28%，p = 0.09）。然而，在随访期间（降脂饮食的中位时长为4.52年），54%的heFH受试者FMD恶化，其恶化与低密度脂蛋白胆固醇的升高相关（r = -0.21，p < 0.05）。此外，男性（β = -0.46，p = 0.03）、进入青春期（β = -0.61，p = 0.03）和体重指数标准差评分增加（β = -0.39，p = 0.03）被确定为FMD下降的主要独立预测因素。
在生命的最初几十年里，不仅高胆固醇血症，而且促动脉粥样硬化状况的聚集及其持续存在，都可能影响内皮功能及其趋势。（www.actabiomedica.it）
