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1.
Przegl Lek ; 60(1): 12-7, 2003.
Artigo em Polonês | MEDLINE | ID: mdl-12884639

RESUMO

UNLABELLED: In last years it has been proved that atherosclerosis risk factors are present in children and adolescents, and that already in their young age they are connected with anatomic, atherosclerosis changes in vessels. The aim of the study was to evaluate levels of selected new atherosclerosis risk factors (Lp(a), apo A-I, apo B, homocysteine, fibrinogen) and markers of fibrinolysis (t-PA and PAI-1) in children and adolescents with traditional risk factors (obesity, hypertension, diabetes). MATERIALS AND METHODS: The study group consisted of 285 children and adolescents aged 14.3 yrs. Children were divided according to their main disease into groups: children with obesity (n = 49), children with obesity and coexisting hypertension (n = 56), children with hypertension (n = 58) and children with diabetes (n = 122). Control group consisted of 79 healthy children and adolescents aged 13.3 yrs. Lp(a), apo A-I and apo B levels were estimated by use of immunoturbidimetric methods, total homocysteine, fibrinogen, t-PA and PAI-1 were estimated by use of immunoenzymatic methods. RESULTS: Lp(a) level in the total study group was 0.30 g/L and was over twice higher than in the control group -0.14 g/L. Apo A-I level was significantly lower in obese children (1.27 g/L) and in the group with obesity and coexisting hypertension (1.25 g/L) vs 1.35 g/L in controls. Apo B level was significantly higher in the total study group (0.86 g/L) and in groups with obesity, obesity and coexisting hypertension and diabetic children vs 0.73 g/L in controls. Hcy was higher in the group with obesity and coexisting hypertension (8 mumol/L) and in the group with hypertension (9.4 mumol/L) vs 6.2 mumol/L in control group. FB level was higher in the total study group (2.76 g/L) and in groups of obese children (3.18 g/L) and obesity coexisting with hypertension (3.22 g/L) vs 2.52 g/L in controls. Significantly higher t-PA level was found in the obese group (9 micrograms/L) and obesity with hypertension group (9.7 micrograms/L) vs 7.3 mg/L in controls, and PAI-1 level was significantly higher in total study group (62.3 micrograms/L) and groups of obese children (73.8 micrograms/L), obese and hypertensive (78 micrograms/L) and hypertensive (73 micrograms/L) vs 42.4 micrograms/L in control group. 28% of study children had positive family history of cardiovascular diseases. CONCLUSION: 1. Young patients with obesity, hypertension or obesity present significant lipid metabolism disturbances, regarding mainly total cholesterol, LDL, triglycerides, and Lp(a) and apo B levels. Unfavourable lipid profile is characteristic mainly in children with obesity and coexisting hypertension. 2. Elevated homocysteine level is found in children with hypertension. 3. Elevated fibrinogen level and diminished fibrinolytic activity characterises obese children. 4. Children and adolescents with obesity, hypertension or diabetes often come from families with positive family history of cardiovascular diseases and other atherosclerosis risk factors.


Assuntos
Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/etiologia , Diabetes Mellitus Tipo 1/complicações , Fibrinólise , Hipertensão/complicações , Obesidade/complicações , Adolescente , Adulto , Apolipoproteína A-I/sangue , Apolipoproteínas B/sangue , Biomarcadores/sangue , Fatores de Coagulação Sanguínea/metabolismo , Estudos de Casos e Controles , Criança , Pré-Escolar , Doença da Artéria Coronariana/genética , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/genética , Ensaio de Imunoadsorção Enzimática , Feminino , Fibrinogênio/metabolismo , Homocisteína/sangue , Humanos , Hipertensão/sangue , Hipertensão/genética , Lipoproteína(a)/sangue , Masculino , Obesidade/sangue , Obesidade/genética , Inibidor 1 de Ativador de Plasminogênio/sangue , Polônia , Fatores de Risco , Fatores de Tempo , Ativador de Plasminogênio Tecidual/sangue , Resultado do Tratamento
2.
Atherosclerosis ; 167(2): 275-86, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12818410

RESUMO

UNLABELLED: In the last few years it has been proved that risk factors for atherosclerosis are present in children and adolescents, and that already at this early age they are connected with anatomic, atheromatous changes in vessels. These changes can not be fully explained as occurring in young people exhibiting traditional risk factors for the disease. The aim of the study was to evaluate levels of several new atherosclerosis risk factors (lipoprotein (a) (Lp(a)), apolipoprotein A-I (Apo A-I), apolipoprotein B (Apo B), homocysteine (Hcy), fibrinogen (FB), tissue plasminogen activator (t-PA) and tissue plasminogen activator inhibitor type 1 (PAI-1)) in children and adolescents with traditional risk factors (obesity, hypertension, diabetes). MATERIALS AND METHODS: The study group consisted of 285 children and adolescents aged 14.3 years. Children were divided according to their main disease into groups: group A, children with obesity (n=49); group B, children with obesity and coexisting hypertension (n=56); group C, children with hypertension (n=58) and group D, children with diabetes (n=122). Control group consisted of 79 healthy children and adolescents aged 14.1 years. Lp(a), Apo A-I and Apo B levels were estimated by use of immunoturbidimetric methods; total Hcy, FB, t-PA and PAI-1 were estimated by use of immunoenzymatic methods. RESULTS: Lp(a) level in the total study group was 30 mg/dl and was over twice higher than in control group, 14 mg/dl. Apo A-I level was significantly lower in group A (127.6 mg/dl) and in group B (125.8 mg/dl) versus 135.6 mg/dl in controls. The level of Apo B was significantly higher in total study group (86.2 mg/dl) and in groups A, B and D versus 73.5 mg/dl in controls. Hcy was higher in group B (8 micromol/l) and in group C (9.4 micromol/l) versus 6.2 micromol/l in the control group. The FB level was higher in the total study group (276.7 mg/dl) and in groups A (318.8 mg/dl) and B (322.6 mg/dl) versus 252.8 mg/dl in controls. Significantly higher t-PA level was found in groups A (9 ng/ml) and B (9.7 ng/ml) versus 7.3 ng/ml in controls, and PAI-1 level was significantly higher in the total study group (62.3 ng/ml) and in groups A (73.8 ng/ml), B (78 ng/ml) and C (73 ng/ml) versus 42.4 ng/ml in the control group. Correlation analysis showed significant relationship between body mass index (BMI) and Apo B, Hcy, FB, t-PA and PAI-1. Blood pressure values correlated positively with Hcy. Correlations were verified in multiple regression analysis models: FB and t-PA levels depended on BMI, and Hcy depended on systolic blood pressure. CONCLUSIONS: (1) Young obese, hypertensive and diabetic patients present significant disturbances in lipid metabolism, regarding mainly total cholesterol, LDL, triglycerides, as well as Lp(a), Apo A-I and Apo B levels. Unfavourable lipid profile is characteristic mainly for children with obesity and accompanying hypertension. (2) Elevated Hcy levels are found in children with hypertension. (3) Elevated FB level and diminished fibrinolytic activity are characteristic of obese children.


Assuntos
Arteriosclerose/epidemiologia , Diabetes Mellitus Tipo 1/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Análise de Variância , Apolipoproteínas/análise , Arteriosclerose/diagnóstico , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Estudos de Coortes , Comorbidade , Diabetes Mellitus Tipo 1/diagnóstico , Feminino , Humanos , Hipertensão/diagnóstico , Incidência , Modelos Lineares , Lipoproteínas HDL/análise , Lipoproteínas LDL/análise , Masculino , Obesidade/diagnóstico , Probabilidade , Valores de Referência , Fatores de Risco , Distribuição por Sexo , Estatísticas não Paramétricas
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