Own and Parental Predictors of Hypertriglyceridemia in Children of Persons with Early Ischemic Heart Disease

Abstract

Aim: to elucidate predictors of high level of basal triglycerides (TG) in blood of children of persons with early (onset: men ≤55, women ≤60 years) ischemic heart disease (EIHD).Materials and methods. We examined 316 families: patients (probands) (n=295; 77.9 % after MI) with EIHD, their spouses (n=219; 83.1 % women) and native children of probands (n=413; 55.7 % men) aged 5–38 years. In children aged 5–17 and 18–38 years proband’s spouse was mother in 88 and 77 % of cases, respectively. Hypertriglyceridemia in children (HTG) was defined in persons aged 5–17 years as ≥90 percentile (Lipid Research Clinics), ≥18 years – ≥1.7 mmol / l or HTG drug treatment. Predictors of HTG were selected by binary logistical regression with adjustment for age, sex and drugs.Results. HTG was found in 31 / 158 children aged 5–17 years. Its independent predictors were systolic arterial pressure (odds ratio [OR] of top [>108] vs. two bottom [≤108 mm Hg] tertiles 3.85, 95 % confidence interval [CI] 1.38–10.7, р=0.010), heart rate (HR, OR of top [>78] vs. two bottom [≤78 bpm] tertiles 2.94, 95 % CI 1.20–7.23, р=0.019), and high density lipoprotein cholesterol (HDL–C, OR 0.35, 95 % CI 0.13–0.94; р=0.038) of their children; HR (OR of top [>72] vs. two bottom [≤72 bpm] tertiles 3.56, 95 % CI 1.38–9.11, р=0.008), low density lipoprotein cholesterol (OR 2.49, 95 % CI 1.12–5.52, p=0.025]), and type 2 diabetes (OR 25.9, 95 % CI 1.01–665.3; p=0.049) of the parent – proband’s consort. HTG was found in 35 / 255 children aged 18–38 years and was associated with own age (OR 1.10, 95 % CI 1.02–1.19, р=0.012) and male sex (OR 6.21, 95 % CI 2.45–15.8; р=0.000). HTG was independently associated with body mass index (OR top [>25.4] vs. two bottom [≤25.4 kg / m2] tertiles 4.94, 95 % CI 2.13–11.4, р=0.000); basal glycemia (OR top [5.1] vs. two bottom [≤5.1 mmol / l] tertiles 2.52, 95 % CI 1.17–5.43, р=0.019); HDL–C (OR 0.17, CI 0.04–0.81, 0.027); alcohol consumption (OR consuming more than once vs. once a week and less 2.27, 95 % CI 1.02–5.02, p=0.044) of these children; HDL–C (OR 0.19, 95 CI 0.04–0.94; p=0.041) of the proband-parent.Conclusions. HTG in children aged 5–38 years with parental early IHD was independently associated mainly with own characteristics, forming components of metabolic syndrome. Attention should be paid to the dominance of maternal transmission in children and adolescents (age group 5–17 years).

Modern Aspects of the Clinic, Diagnosis and Treatment of Prediabetes

“…В ходе когортных исследований получена информация о распространенности предиабета среди населения (табл. 1 [6][7][8][9][10][11][12][13][14]), однако, оценки варьируются в зависимости от порогов, используемых в диагностики предиабета, и основных характеристик населения [4,5]. Недавние исследования, проведенные в США и Великобритании, указывают на то, что распространенность предиабета у взрослых составляет 38% и 35% соответственно [5].…”

“…Гендерные различия в распространенности нарушений углеводного обмена отсутствовали [12]. По результатам другого анализа, предиабет детей, подростков и молодых взрослых с родительским анамнезом ранней ИБС независимо ассоциируется прежде всего с метаболическим синдромом и его компонентами [7]. Крупное популяционное исследование, направленное на изучение ФР, связанных с невыявленной НТГ у здоровых молодых людей (моложе 40 лет), было проведено в Корее.…”