Lipoprotein(a) levels in children and adolescents: Ouro Preto Study

Abstract Background Lipoprotein (a) is a cardiovascular risk factor in adult. Studies have shown the presence of this emergent risk factor in school children, which may contribute to the development of atherosclerosis in adulthood. Objective To evaluate the association between lipoprotein (a) and cardiovascular risk factors in school children. Methods Lipoprotein (a) levels were measured in 320 school children (6-14 years) selected from a population survey carried out in Ouro Preto (southeast of Brazil). Demographic (sex and age), biochemical (total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, triglycerides, and glucose), anthropometric (body mass index, waist circumference, body fat percentage), clinical (arterial blood pressure, pubertal stage and birth weight) and economic (family income) parameters, as well as family history (obese and/or hypertensive parents) were analyzed. Non-parametric analysis was used to evaluate lipoprotein (a) levels in each subgroup. Variables with p≤0.20 in the univariate analysis were included in binary regression logistic model. Differences with p < 0.05 were considered significant. Results Lipoprotein (a) levels were associated with total cholesterol (p=0.04), body fat (p=0.009), and mother´s systolic (p=0.02) and diastolic blood pressure (p=0.04). In a logistic regression analysis, children with high lipoprotein (a) levels and body fat, and children born from hypertensive mothers were, respectively, at 3.2(p=0.01) and 1.4 (p=0.03) times higher risk than other children. In clustering these factors, elevated lipoprotein (a) was 2.6 times more likely to be seen in school children with high body fat and born hypertensive mothers. Conclusions Lipoprotein (a) was correlated with cardiovascular risk factors in children and adolescents. Persistence of these risk factors in childhood suggests a contribution of elevated lipoprotein (a) to future cardiovascular disease. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

Cluster randomised trial to evaluate the effectiveness of a vaccine against cutaneous leishmaniasis in the Caratinga microregion, south-east Brazil.

BACKGROUND: The eco-epidemiological complexity of American cutaneous leishmaniasis (ACL) has made it difficult to devise an efficient strategy for management of the disease, and development of an effective vaccine remains the most promising approach. The objective of the study was to determine the reduction in incidence of ACL following intramuscular administration of two doses of a killed Leishmania (Leishmania) amazonensis vaccine. METHODS: A cluster randomised trial was conducted from 2002 to 2011 in 108 localities in an endemic area of southeast Brazil. Communities were stratified according to population size, and randomly allocated to receive vaccine (n = 50) or placebo (n = 58). The post-vaccination ACL incidence rates in the two groups were compared through covariance analysis. RESULTS: A cyclic fluctuation in the number of cases recorded during the 18-year pre-vaccination period was similar in both groups. Following the vaccination campaign, a significant reduction in the number of cases of ACL was observed in the vaccine group compared with the placebo group. This group also included the individuals who refused to participate in the trial. CONCLUSION: This study demonstrated that the vaccine has been able to confer protection against ACL up to the present time. It is necessary to continue epidemiological surveillance to determine the duration of the vaccine's effectiveness.