Helk Oliver, Böck Andreas, Stefanutti Claudia, Widhalm Kurt
Department of Nephrology and Dialysis, Medical University of Vienna, Austria.
University Department for Paediatrics and Adolescent Medicine, Medical University of Vienna, Austria.
Atheroscler Plus. 2022 Nov 26;51:1-7. doi: 10.1016/j.athplu.2022.11.001. eCollection 2023 Mar.
Combined hyperlipidaemia results in premature atherosclerosis and a high burden of cardiovascular morbidity and mortality. Early identification of highly affected subjects within this population is of utmost importance to enable informed treatment decisions. The measurement of intima media thickness (IMT) is a readily available, non-invasive method to investigate evidence of early atherosclerosis. To assess the usefulness of this method in pediatric subjects with hypercholesterolemia, we here examined a possible interaction of LDL-C and Lp(a) on IMT.
Blood lipids (Lp(a), LDL-cholesterol, total cholesterol, triglycerides, high density lipoprotein (HDL) -cholesterol, apolipoprotein A1, apolipoprotein B), anthropometric parameters (age, height, weight, body mass index (BMI)) and possibly existing early evidence of atherosclerotic lesions measured by intima media thickness (IMT zscore).as a surrogate parameter was examined retrospectively in 113 children and adolescents (aged 1-18 years) with elevated Lp(a) and/or LDL-cholesterol (Lp(a) > 30 mg/dL, LDL>130 mg/dL). Furthermore, we compared hsCRP levels between groups.
There were no significant differences in IMT Zscore or hsCRP between groups. Regression analysis did not reveal a statistically significant interaction between Lp(a) and LDL-C.
At the age of 6-18 years, we found no significant differences in early markers of atherosclerosis between subjects with high Lp(a)- and/or high LDL-cholesterol with no detectable synergistic effects between the two lipoproteins.
混合性高脂血症会导致动脉粥样硬化提前发生,并带来心血管疾病发病和死亡的高负担。在这一人群中尽早识别出受影响严重的个体对于做出明智的治疗决策至关重要。内膜中层厚度(IMT)测量是一种现成的、非侵入性的方法,用于研究早期动脉粥样硬化的证据。为了评估该方法在患有高胆固醇血症的儿科患者中的实用性,我们在此研究了低密度脂蛋白胆固醇(LDL-C)和脂蛋白(a)[Lp(a)]对IMT的可能相互作用。
回顾性检查了113名Lp(a)和/或LDL-胆固醇升高(Lp(a)>30mg/dL,LDL>130mg/dL)的儿童和青少年(1至18岁)的血脂(Lp(a)、低密度脂蛋白胆固醇、总胆固醇、甘油三酯、高密度脂蛋白(HDL)-胆固醇、载脂蛋白A1、载脂蛋白B)、人体测量参数(年龄、身高、体重、体重指数(BMI))以及通过内膜中层厚度(IMT z评分)测量的可能存在的早期动脉粥样硬化病变证据,IMT z评分作为替代参数。此外,我们比较了各组之间的高敏C反应蛋白(hsCRP)水平。
各组之间的IMT Z评分或hsCRP无显著差异。回归分析未发现Lp(a)与LDL-C之间存在统计学上的显著相互作用。
在6至18岁的年龄段,我们发现Lp(a)高和/或LDL-胆固醇高的受试者之间,动脉粥样硬化早期标志物无显著差异,且这两种脂蛋白之间未发现协同效应。