Background: Dyslipidaemia is a well-known risk factor in developing cardiovascular disease (CVD) already in childhood.
Objective and hypotheses: To investigate the clustering of cardiovascular risk-factors (anthropometric parameters, blood pressure and metabolic abnormalities) in different type of dyslipidaemia in children and adolescents.
Method: All the subjects aging 218 years referred for dyslipidaemia to our endocrine outpatient clinic between April 1999 and June 2014 were included. Categories of dyslipidaemia comprise: genetic-confirmed familial hypercholesterolemia (FH), hypercholesterolemia (XH), isolated hypertriglyceridemia (hyperTG), combined hyperlipidaemia (CH), isolated deficiency of HDL (idHDL), dyslipidaemia not otherwise classified (NAS). Familial history of precocious CVD (F+), anthropometric parameters (BMI-SDS, waist circumference (WC), waist-to-hip ratio (WHR)), systolic blood pressure (SBP), lipid profile, fasting glycaemia (G), insulin (Ins) and liver enzymes (AST, ALT) were collected in all the enrolled patients.
Results: Among 1245 included subjects (median age 9.8, range 217.6 years; 95.7% Caucasian), 813 (65.3%) were confirmed dyslipidaemic: 5.6% FH, 25.6% XH, 27.2% hyperTG, 28.5% CH, 1.8% idHDL, 11.3% NAS. Among categories, BMI-SDS was greater in CH and hyperTG (P<0.000) and WC was higher in XH, hyperTG and CH (P 0.001), even if WHR did not differ significantly. High levels of SBP were more frequently detected among FH, hyperTG and CH subjects (31.1, 31.5 and 30.4% respectively). TC and LDL-C were higher in FH (P<0.000), while hyperTG and CH presented elevated TG (P<0.000). HDL-C was lower in idHDL and hyperTG (P<0.000). FH showed greater TC/LDL, LDL/HDL and ApoB/ApoA-1 ratios. ALT, Ins levels and HOMA index were increased in hyperTG and CH (P 0.018, <0.000, <0.000 respectively). The odds ratio for F+ was 8.72 in FH, 0.76 in XH, 0.70 in hyperTG, 1.07 in CH and 3.63 in idHDL.
Conclusions: We demonstrated the evidence of a specific cluster of pro-atherogenic conditions among different categories of dyslipidaemia increasing sinergically the cardiovascular risk already in childhood.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology