Assessment of cardiovascular risk factors in children and adolescents with dyslipidemia

Doctoral Dissertation uoadl:2864654 307 Read counter

Faculty of Medicine
Library of the School of Health Sciences
Deposit date:
Klinaki Eleni
Dissertation committee:
Γουργιώτης Δημήτριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Τσολιά Μαρία, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Γαρούφη Αναστασία, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπουσα
Κόσσυβα Λυδία, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σπυρίδης Νικόλαος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αττιλάκος Αχιλλέας, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βάρτζελης Γιώργος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Εκτίμηση παραγόντων καρδιαγγειακού κινδύνου σε παιδιά και εφήβους με δυσλιπιδαιμία
Translated title:
Assessment of cardiovascular risk factors in children and adolescents with dyslipidemia
Background: The pathophysiologic mechanisms which lead to cardiovascular (CV) events begin early in childhood. Atherosclerosis is recognized as a chronic and dynamic process induced primarily by vascular inflammation and endothelial dysfunction. Asymmetric dimethylarginine (ADMA) and lipoprotein associated phospholipase A2 (Lp-PLA2) are considered markers of early atherosclerosis and predictors of late complications in adulthood.
Aim: To establish the relationship between ADMA, Lp-PLA2 and traditional cardiovascular risk biomarkers in children and adolescents with dyslipidemia or diabetes mellitus type 1.
Material and Methods: The study population consisted of 123 chilren, 68 males / 55 females, with a median age of 9.9 years. 73 children suffered dyslipidemia (LDL-C levels ≥ 130 mg/dl), 19 children suffered diabetes mellitus type 1 and 31 were apparently healthy children. Blood samples were obtained after an overnight fasting. Lipid, lipoproteins, hsCRP, glucose, HbA1c, as well as ADMA and Lp-PLA2 levels were estimated. LDL-C concentration was directly measured. ADMA and Lp-PLA2 levels were assessed by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using STATA for Windows v8.5. p < 0.05 was considered statistically significant.
Results: Children suffering dyslipidemia demonstrated higher ADMA and Lp-PLA2 levels. ADMA was significantly positively correlated with TC, LDL-C, non-HDL-C and TGs. Even small changes of the ADMA concentration in dyslipidemic children were found to be followed by corresponding alterations in lipid-lipoprotein levels. A significant positive correlation was observed between Lp-PLA2 and hsCRP as well as a positive correlation of borderline significance between Lp-PLA2 and LDL-C or non-HDL-C. In addition, ADMA and Lp-PLA2 were strongly correlated. In the group of diabetes mellitus, ADMA levels were significantly negatively correlated with age and Lp-PLA2 levels were marginaly correlated with TGs levels.
Conclusions: A relationship of ADMA and Lp-PLA2 levels with biochemical markers associated with long-term risk of atherosclerosis in children and adolescents is supported. The assessment of these two biomarkers combined may improve CV risk prediction and future management strategies in the pediatric population.
Main subject category:
Health Sciences
Asymmetric dimethylarginine (ADMA), Lipoprotein-associated phospholipase A2 (Lp-PLA2), Children, Dyslipidemia, Diabetes Melitus
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