Medical Student Scientific Society, Department of Pediatrics and Pediatric Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Poland.
Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland.
Pediatr Endocrinol Diabetes Metab. 2022;28(2):108-113. doi: 10.5114/pedm.2022.116114.
There is a significant correlation between elevated LDL cholesterol (LDL-C) levels sustained from childhood and future vascular disease. The study aimed to evaluate the effectiveness and safety of the therapy chosen for children with lipid disorders.
The study group consisted of 37 children with increased LDL-C (13 boys) aged 8.99 ±4.03 years. After 6 months of behavioral treatment, study group was divided into G1 (n = 24) which continued non-pharmacological treatment supported by dietary supplements and G2 (n = 13) in which statin (5-10 mg/day) was added to non-pharmacological treatment. Analysis included: BMI Z-score, total cholesterol (TCh), LDL-C, HDL cholesterol (HDL-C) and triglycerides (TG) measured at several time points.
The concentrations of TCh and LDL-C before treatment were significantly higher in G2 than in G1 (p < 0.001). Due to the treatment, these differences were no longer noticeable at the last visit. In G1 and G2 concentrations of TCh and LDL-C were reduced significantly, greater reduction after the treatment in TCh and LDL-C was observed in G2 than in G1. Moreover, in G1 we noticed reduction of TG after treatment (p < 0.05). The BMI Z-score did not change significantly through the treatment in both groups. G1 also showed a significant negative correlation between BMI Z-score and HDL-C before and after treatment (r = -0.57, p = 0.009; r = -0.52, p = 0.02). Same relationship was noticed also in G2 after treatment (r = 0.67, p = 0.05).
In children with dyslipidemia, regardless of its background, statin therapy is the most effective in lowering LDL-C. However, therapy with lipids-lowering supplements seems to be safe and effective.
儿童时期 LDL 胆固醇（LDL-C）水平升高与未来的血管疾病有显著相关性。本研究旨在评估针对血脂异常儿童选择的治疗方法的有效性和安全性。
研究组包括 37 名 LDL-C 升高的儿童（13 名男孩），年龄为 8.99±4.03 岁。经过 6 个月的行为治疗后，研究组分为 G1 组（n=24），继续接受非药物治疗，并辅以饮食补充剂；G2 组（n=13）则在非药物治疗的基础上加用他汀类药物（5-10mg/天）。分析包括：在多个时间点测量体重指数（BMI）Z 评分、总胆固醇（TCh）、LDL-C、高密度脂蛋白胆固醇（HDL-C）和甘油三酯（TG）。
治疗前，G2 组的 TCh 和 LDL-C 浓度明显高于 G1 组（p＜0.001）。由于治疗，最后一次就诊时这些差异不再明显。在 G1 和 G2 组中，TCh 和 LDL-C 的浓度均显著降低，且 G2 组治疗后的降低幅度大于 G1 组。此外，在 G1 组中，我们观察到治疗后 TG 降低（p＜0.05）。两组治疗过程中 BMI Z 评分均无显著变化。G1 组治疗前后 BMI Z 评分与 HDL-C 呈显著负相关（r=-0.57，p=0.009；r=-0.52，p=0.02）。G2 组治疗后也出现同样的相关性（r=0.67，p=0.05）。
对于血脂异常的儿童，无论其病因如何，他汀类药物治疗在降低 LDL-C 方面最为有效。然而，降脂补充剂治疗似乎是安全有效的。
