Lipoprotein(a) and family history for cardiovascular disease in paediatric patients: A new frontier in cardiovascular risk stratification. Data from the LIPIGEN paediatric group.

Autor: Pederiva C; Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Paediatrics Unit, ASST-Santi Paolo e Carlo, 20142, Milan, Italy. Electronic address: cristina.pederiva@asst-santipaolocarlo.it., Capra ME; Centre for Paediatric Dyslipidaemias, Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121, Piacenza, Italy., Biasucci G; Centre for Paediatric Dyslipidaemias, Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121, Piacenza, Italy. Electronic address: g.biasucci@ausl.pc.it., Banderali G; Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Paediatrics Unit, ASST-Santi Paolo e Carlo, 20142, Milan, Italy., Fabrizi E; DISES & DSS, Università Cattolica Del S. Cuore, Via Emilia Parmense 84, 29122, Piacenza, Italy., Gazzotti M; Fondazione SISA (Società Italiana per lo Studio dell'Aterosclerosi), Via Giuseppe Balzaretti 7, 20133, Milano, Italy., Casula M; Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy., Catapano AL; Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy; IRCCS MultiMedica, Sesto S. Giovanni (MI), Italy., Arca M; Dipartimento di Medicina Traslazionale di Precisione, Sapienza Università di Roma - A. U. O Policlinico Umberto I, Rome, Italy., Averna M; Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza, Università degli studi di Palermo, Palermo, Italy., Bertolini S; Department of Internal Medicine, University of Genova, Genova, Italy., Calandra S; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy., Catapano AL; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, IRCCS Multimedica, Milan, Italy., Tarugi P; Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy., Pellegatta F; Centro per lo Studio dell'Aterosclerosi, IRCCS Multimedica, Sesto San Giovanni, Italy; Centro per lo Studio dell'Aterosclerosi, Ospedale E. Bassini, Cinisello Balsamo, Milan, Italy.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2022 May; Vol. 349, pp. 233-239. Date of Electronic Publication: 2022 Apr 25.
DOI: 10.1016/j.atherosclerosis.2022.04.021
Abstrakt: Background and Aims: Little is known about the role of Lp(a) in the assessment of cardiovascular risk in the paediatric population. Trying to clarify the clinical relevance of Lp(a) in risk stratification, the aim of the study is to evaluate the association between Lp(a) plasma levels in children with familial hypercholesterolaemia (FH) and positive family history for premature cardiovascular disease (pCVD) in first- and second-degree relatives.
Methods: 653 Caucasian children and adolescents (334 females and 319 males), aged 2-17 years, with diagnosis of FH from a paediatric cohort included in the LIPIGEN Network, were selected. We compared family history of pCVD, lipid and genetic profile in two groups based on Lp(a) levels below or above 30 mg/dL. To determine the independent predictors of pCVD, a multivariate logistic regression was used, with all clinical characteristics and blood measurements as predictors.
Results: Subjects with Lp(a) > 30 mg/dl more frequently reported positive family history of pCVD compared to subjects with Lp(a)≤30 mg/dl (69.90% vs 36.66%, p < 0.0001), while did not show differences in terms of median [interquartile range] LDL-cholesterol level (153.00 [88.00 vs 164.50 [90.25] mg/dL, p = 0.3105). In the regression analysis, Lp(a) > 30 mg/dl was an independent predictor of family history of pCVD. Comparing subjects with or without family history of pCVD, we reported significant differences for Lp(a) > 30 mg/dl (46.25% vs 17.65%, p < 0.0001), FH genetic mutation (50.48% vs 40.75%, p = 0,0157), as well as for LDL-cholesterol (p = 0.0013) and total cholesterol (p = 0.0101).
Conclusions: Children/adolescents with FH and Lp(a) > 30 mg/dl where more likely to have a positive family history of pCVD. Lp(a) screening in children and adolescents with FH may enhance risk assessment and help identify those subjects, children and relatives, at increased pCVD risk.
(Copyright © 2022. Published by Elsevier B.V.)
Databáze: MEDLINE
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