Cholesterol and carotid artery wall in children and adolescents with familial hypercholesterolaemia: a controlled study by ultrasound

Abstract

The carotid artery wall was studied with ultrasound in 23 children and adolescents with familial hypercholesterolaemia and in 23 age-matched healthy controls. The study revealed changes in the carotid artery wall related both to familial hypercholesterolaemia and to age. In the control subjects, the carotid artery wall became stiffer with age. In the patients with hypercholesterolaemia, no clear age-dependence was found, but wall stiffness correlated with total and low-density lipoprotein cholesterol. The intimal-medial wall thickness was associated with serum total cholesterol, low-density lipoprotein and triglyceride concentrations, and correlated inversely with the ratio of high-density lipoprotein to total cholesterol. Carotid artery wall properties seem to be associated with the degree of hypercholesterolaemia and the high-density lipoprotein-to-total cholesterol ratio even in children. In childhood and adolescence it is already possible, with ultrasound, to detect changes in the arterial wall related both to familial hypercholesterolaemia and to age.

Family History and Cardiovascular Risk in Familial Hypercholesterolemia

“…3,4 Along with these functional changes, accumulation of cholesteryl esters changes the vascular morphology, and the intima-media thickness of peripheral arteries increases more rapidly in children with FH. 5,6 These findings support the notion of taking preventive measures when children are young instead of waiting until FH heterozygotes reach adulthood. In particular, it has been suggested that lifestyle changes in these children can influence plasma LDL-C 7 : The largest and longest placebocontrolled trial with statin therapy showed excellent safety and efficacy in children with FH.…”

Common Carotid Intima-Media Thickness and Arterial Stiffness

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Furthermore, a positive relationship between IMT and risk scores was also reported for the British Heart Study, Framingham, and EPOZ risk scores. [41][42][43] However, these studies concerned general populations, ie, subjects who were on average at a relatively low risk for cardiovascular disease, whereas the present study was conducted in a population at high risk.…”

“…Cross-sectional studies showed associations between decreased distensibility and cardiovascular risk factors, ie, hypertension, diabetes mellitus, hypercholesterolemia, and myocardial infarction. [12][13][14][15][16][17][18][19] In contrast to these findings in the general population, little is known of an association of IMT and distensibility with cardiovascular risk in patients who are already at high risk of cardiovascular disease. In the present study, we evaluate to what extent previously reported associations of IMT and distensibility with cardiovascular risk also apply to patients who have more severe disease.…”

Squalene and Noncholesterol Sterols in Serum and Lipoproteins of Children with and without Familial Hypercholesterolemia

“…Thus, even though the ratios of noncholesterol sterols to cholesterol in serum reflect, in general, synthesis and absorption of cholesterol, their ratios in different lipoproteins could give additional information of cholesterol metabolism. The deranged catabolism of apo B containing LDL increases serum cholesterol levels in FH (1), even already at birth (2), resulting in development of arterial atherosclerotic lesions already at the ages of 3-19 y (3,4). In addition to cholesterol, other minor sterols, called noncholesterol sterols, and squalene are also carried by serum lipoproteins.…”