Family history of cardiovascular disease and non-HDL cholesterol in prepubescent non-obese children / Importância clínica da história familiar de doença cardiovascular e da dosagem do colesterol não HDL em crianças eutróficas

ABSTRACT

Summary Objective: To describe the values of non-HDL cholesterol (NHDL-c) and the frequency of a family history of early cardiovascular disease (family HCVD) in healthy prepubescent children. Analyze the association between NHDL-c and family HCVD, and possible associations with other risk factors for cardiovascular disease (CVD). Method: Cross-sectional study including 269 prepubescent (aged 6-10 years) schoolchildren with a normal body mass index (+1SD<BMI>-2SD). Data collected Family HCVD; weight and height, waist circumference and systemic blood pressure; lipid profile (total cholesterol TC, HDL-c, triglycerides and LDL-c), NHDL-c calculation (CT-HDL-c, cut-off = 145 mg/dL) and insulin resistance (HOMA-IR). Results: High levels were found for NHDL-c in 10 (3.7%) of these schoolchildren, and family early HCVD was found in 46 (17.1%) of them. There was a weak association between family HCVD and NHDL-c (Cramer’s-V-test = 0.120; p=0.050). Among the children with NHDL-c≥145 mg/dL, 4 (40%) have family HCVD. The presence of family HCVD was not associated with the variables being studied. The variables independently associated with NHDL-c ≥ 145 mg/dL were HOMA-IR (OR=1.7; 95CI 1.1-2.6) and diastolic blood pressure (OR=1.1; 95CI 1.02-1.2). Conclusion: NHDL-c values were associated with blood pressure and insulin resistance. Family HCVD was not associated with other classic risk factors for CVD, even though the frequency found was five times higher than that of high NHDL-c.

RESUMO

Resumo Objetivos: descrever os valores do colesterol não HDL (NHDL-c) e a frequência de história cardiovascular familiar precoce (HDCV familiar) em crianças eutróficas e pré-púberes. Analisar a associação entre o NHDL-c e o HDCV familiar e possíveis associações com outros fatores de risco para doenças cardiovasculares (DCV). Método: estudo transversal com 269 escolares (6-10 anos) pré-púberes e com índice de massa corporal normal (+1DP<IMC>-2DP). Dados coletados HDCV familiar; peso e estatura, circunferência abdominal e pressão arterial sistêmica; perfil lipídico (colesterol total – CT, HDL-c, triglicérides e LDL-c), cálculo do NHDL-c (CT-HDL-c, ponto de corte 145 mg/dL) e resistência à insulina (HOMA-IR). Resultados: observaram-se valores elevados de NHDL-c em 10 (3,7%) e presença de HDCV familiar precoce em 46 (17,1%) crianças. Houve fraca associação entre HDCV familiar e NHDL-c (Cramer’s-V-test = 0,120; p=0,050). Entre as crianças com NHDL-c ≥145 mg/dL, quatro (40%) tinham HDCV familiar. A presença de HDCV familiar não se associou com as variáveis estudadas. As variáveis que se associaram de forma independente com o NHDL-c ≥145 mg/dL foram HOMA-IR (OR=1,7; IC95% 1,1-2,6) e pressão arterial diastólica (OR=1,1; IC95% 1,02-1,2). Conclusão: os valores de NHDL-c se associaram com pressão arterial e resistência insulínica. HDCV familiar não se associou com outros fatores de risco clássicos para DCV, embora a frequência encontrada tenha sido quase cinco vezes superior à de NHDL-c elevado.