Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Pediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Pediatr Blood Cancer. 2024 Oct;71(10):e31236. doi: 10.1002/pbc.31236. Epub 2024 Jul 31.
Pediatric arterial ischemic stroke (AIS) is a rare disorder, associated with severe morbidity. In adults, elevated lipoprotein(a) (Lp(a)), a cholesterol-like particle, is associated with ischemic stroke. However, data on Lp(a) and pediatric AIS are scarce. Therefore, we evaluated the association between Lp(a) levels and pediatric AIS.
We included children who suffered an AIS (≤18 years) and were treated in a tertiary center in Amsterdam, the Netherlands. Two groups of children with AIS were identified: (i) neonates and (ii) children older than 29 days. A case-control study was performed, with the latter group as cases and children without AIS as control group. Cases and controls were matched for age of Lp(a) testing and sex. Multivariable logistic regression models were used.
Thirteen neonates and 23 children were included. Mean (SD) age of AIS was 0.6 (2.0) days and 9.2 (6.3) years, respectively. Children with AIS were matched to 62 controls. Lp(a) levels of greater than 50 mg/dL were more prevalent in children with AIS compared to controls (21.7% vs. 3.2%, p = .02). A significant association was found between Lp(a) and AIS (odds ratio [OR] adjusted for age at Lp(a) testing, body mass index [BMI], measurement assay: 1.36 per 10 mg/dL increase of Lp(a), 95% confidence interval [CI]: 1.02-1.82, p = .041).
In this study, Lp(a) levels were positively associated with the risk of AIS in children, suggesting that high Lp(a) might be an independent risk factor for AIS. This underlines the importance of Lp(a) measurement in children with AIS.
儿科动脉缺血性脑卒中（AIS）是一种罕见的疾病，与严重的发病率有关。在成年人中，升高的脂蛋白（a）（Lp(a)），一种类似胆固醇的颗粒，与缺血性脑卒中有关。然而，关于 Lp(a) 和儿科 AIS 的数据很少。因此，我们评估了 Lp(a) 水平与儿科 AIS 之间的关联。
我们纳入了在荷兰阿姆斯特丹的一家三级中心接受治疗的 AIS（≤18 岁）的儿童。我们确定了两组患有 AIS 的儿童：（i）新生儿和（ii）年龄大于 29 天的儿童。对后者组进行病例对照研究，后者组为病例，无 AIS 的儿童为对照组。病例和对照组按 Lp(a) 检测年龄和性别匹配。采用多变量逻辑回归模型。
纳入了 13 名新生儿和 23 名儿童。AIS 的平均（SD）年龄分别为 0.6（2.0）天和 9.2（6.3）岁。AIS 患儿与 62 名对照患儿相匹配。与对照组相比，患有 AIS 的儿童中 Lp(a)水平大于 50mg/dL 的比例更高（21.7% vs. 3.2%，p=0.02）。Lp(a)与 AIS 之间存在显著相关性（调整 Lp(a) 检测年龄、体重指数（BMI）、检测方法后的比值比[OR]：Lp(a) 每增加 10mg/dL，95%置信区间[CI]：1.02-1.82，p=0.041）。
在这项研究中，Lp(a) 水平与儿童 AIS 的风险呈正相关，表明高 Lp(a) 可能是 AIS 的一个独立危险因素。这突显了在患有 AIS 的儿童中测量 Lp(a) 的重要性。
