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M.V.Konnov*, L.M.Dobordzhginidze, A.D.Deev, N.A.Gratsiansky**

Low level of high density lipoprotein cholesterol in children of patients with premature coronary heart disease. Relation to own and parental characteristics. M.V.Konnov*, L.M.Dobordzhginidze, A.D.Deev, N.A.Gratsiansky**

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M.V.Konnov*, L.M.Dobordzhginidze, A.D.Deev, N.A.Gratsiansky**

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  1. Low level of high density lipoprotein cholesterolin children of patientswith premature coronary heart disease.Relation to own and parental characteristics. M.V.Konnov*, L.M.Dobordzhginidze, A.D.Deev, N.A.Gratsiansky** Center for Atherosclerosis,Institute Of Physico-Chemical Medicine,Moscow, Russian Federation *konnov-mihail@yandex.ru, **n.gra@ru.net http://athero.ru

  2. Background Low level of high density lipoprotein (HDL) cholesterolcan be a critical contributor to elevated riskof coronary heart disease (CHD)in children of patients with premature CHD (PCHD). Purpose To elucidate associations between low HDL-cholesterolin children of patients with PCHD(onset <55 years, men; <60 years, women) with their own and parental characteristics. Konnov MV et al, 2011

  3. In the framework of the study of risk factorsin families of patients with PCHDwe examined members of 285 families: 268 proband-parents (patients with PCHD) aged 32-67 years,70.6% men, 75.7% after MI; 198 their consorts aged 28-67 years, 18.8% men, 3.7% with overt CHD; 371 children of proband-parents aged 5-38 years, 56.9% men, without overt CHD. Material Konnov MV et al, 2011

  4. Parameters registered • alcohol consumption; • tobacco smoking; • oral contraceptive use; • weight; height; • body mass index (BMI); • waist circumference; • heart rate; • systolic/diastolic blood pressure (BP); • arterial prehypertension (PreHT) and hypertension (HT); • total, HDL and low density lipoprotein (LDL) cholesterol; • triglycerides; • basal serum glucose; • impaired glucose tolerance; • diabetes mellitus; • (in adults) education level and presence of menstruation; • metabolic syndrome. Konnov MV et al, 2011

  5. Methods BMI was calculated as follows:(body mass [kg] / height [m2]) LDL-cholesterol - calculated with Friedwald‘s formula High BP was defined as arterial prehypertension or hypertension according to criteria of: -4-th Report of National High BP Education Program Working Group on High BP in children and adolescents criteria (USA) (in persons aged 5-17 years); -7-th Report of Joint National Committee criteria (USA) (in persons aged ≥18 years). For diagnosis of impaired glucose tolerance and diabetesmellitus were used oral glucose tolerance test (1.75 g of glucose per kg body weight up to a total of 75 g for children/adolescents, 75 g for adults, WHO recommendations, 1998), and ADA criteria (2010). Konnov MV et al, 2011

  6. Definition of Metaabolic Syndrome(*Joint Interim Statement 2009 criteria) • Δelevated waist circumference (population and country specific); • elevated triglycerides (≥ 1.7 mmol/l)or drug treatment for this lipid abnormality; • 3. reduced HDL-cholesterol (< 1.0 mmol/l, men; < 1.3 mmol/l, women) or drug treatment for this lipid abnormality; • 4. elevated BP (systolic BP ≥ 130 mm Hgand/or diastolic BP ≥ 85 mm Hg) or antihypertensive drug treatment of previously diagnosed arterial hypertension; • 5. elevated fasting plasma glucose (≥ 5.55 mmol/l)or drug treatment of elevated glucose. *clinical identification (diagnosis) of MS – any 3 of 5 criteria. Δfor people of Europid origin (e.g. participants of this study) IDF cut points can be used – waist: ≥ 94 cm (men), ≥ 80 cm (women)

  7. Statistical methods • Predictors (factors associated with low HDL in children)were selectedby logistical regression analysiswith adjustment for age and sex. • Before logistical regression for reduction of variabilityof continuous coronary risk factors and to suppresspossible outliers symmetric censoring of 1% of their valueswas carried out; Konnov MV et al, 2011

  8. Results Factors associated with low HDL-cholesterolwere elucidated separately in young (age 5-17, n=148)and adult (age 18-38 years, n=223) children. Low HDL cholesterol was found in 47 of 148 (31.8%) children aged 5-17 yearsandin 81 of 223 (36.3%) children aged 18-38 years. Konnov MV et al, 2011

  9. Table 1. Children aged 5-17 years (n=148): Characteristics related to low HDL-cholesterol(n=47, 31.8%) with p<0.1.Results of univariate analysis OR, CI, P – odds ratio, confidence interval and P-level,, respectively Konnov MV et al, 2011

  10. Table 2. Independent predictors of low HDL-cholesterol in children aged 5-17 years. Results of multivariate analysis OR, CI, P – odds ratio, confidence interval and P-level,, respectively Konnov MV et al, 2011

  11. Table 3a. Children aged 18-38 years (n=223): Characteristics related to low HDL-cholesterol(n=81, 36.3%) with p<0.1 Results of univariate analysis (1) Konnov MV et al, 2011

  12. Table 3b.Children aged 18-38 years (n=223): Characteristics related to low HDL-cholesterol(n=81, 36.3%) withp<0.1Results of univariate analysis (2) *additional adjustment for beta-blockers use Konnov MV et al, 2011

  13. Table 4. Independent predictors of low HDL-cholesterol in children aged 18-38 years. Results of multivariate analysis *additional adjustment for beta-blockers usie Konnov MV et al, 2011

  14. Conclusions Low HDL cholesterol was highly prevalent in this group of different age people with parental premature CHD. Independent predictors of low HDL-cholesterol in this sample of children of patients with premature CHDwere mostly metabolic factors both own (body mass index, waist circumference, triglycerides)and parental (low HDL-cholesterol, metabolic syndrome). Konnov MV et al, 2011

  15. OBJECTIVE. To elucidate associations between low HDL-C in children of patients with PCHD (onset <55, men; <60 years, women) and their own and parental characteristics. METHODS. We examined members of 285 families: 268 probands (70.6% men, age 32-67 years), their 198 consorts (18.8% men, 28-67 years, 3.7% overt CHD) and 371 their children (56.9% men, age 5-38 years, no overt CHD). We registered alcohol consumption, smoking, oral contraceptive use, height, body mass index (BMI), waist circumference (WC), heart rate (HR), systolic/diastolic BP, total/low density lipoprotein cholesterol, HDL-C, triglycerides (TG), serum glucose, impaired glucose tolerance, diabetes, arterial pre-/hypertension (NHBPEP-4 or JNC-7 criteria depending on age) and (in adults) education, menstruation status, metabolic syndrome (MS, JIS criteria). Low HDL-C was defined as ≤25 percentile (Lipid Research Clinics, 5-17 years), or <1.0 (men), <1.3 (women) mmol/l (adults). Predictors of low HDL-C were selected by sex, age adjusted logistic regression in 2 age groups: 5-17, 18-38 years. RESULTS. Low HDL-C was found in 47/148 (31.8%) children aged 5-17 years. Its independent predictors were own BMI and low HDL-C of consort. Low HDL-C was found in 81/223 (36.3%) adult children. Its predictors were WC and TG of children, low HDL-C of proband, MS and HR of consort (table). Abstract Independent predictors of low HDL-cholesterol CONCLUSION. In this group of different age people with parental premature CHD independent predictors of low HDL-cholesterol were mostly own (body mass index, waist circumference, triglycerides) and parental (low HDL-cholesterol, metabolic syndrome) metabolic factors. Konnov MV et al, 2011

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