Claudia Stefanutti and Fabio Mazza Pages 1171 - 1181 ( 11 )
256 pediatric patients with primary hyperlipidemia aged 14.2 ± 8.5 years (females: 155; males:101) seen in our lipid clinic were evaluated retrospectively to assess the effect of multiple lipid-lowering treatment (diet only, diet+glucomannan 1.000 mg/day (G), diet+ezetimibe (E) 10 mg/day and diet+atorvastatin (A) 10 mg/day). The patients were assigned to four groups according to their type of treatment: A-Diet (#82; age 12.7 ± 8 years; females 52, males:30); B-Diet+G (#78; age 13.3 ± 9 years; females 61, males 17); C-Diet+E 10 mg/day (#50; age 14.5 ± 7 years; females 31, males 19); D-Diet+A 10 mg/day (#46; age 16.4 ± 10 years; males 35, females 11). The follow-up visits were at 3, 6 and 9 months, respectively. The time period considered was of 9 months. The results obtained in the four groups after 9 months of treatment are given below:Group A: Total Cholesterol (TC) (-20%), LDL-Cholesterol (LDLC) (-26%), triglycerides (TG) (-25%), nonHDLCholesterol (nonHDLC) (-26%) levels, and TC/HDLC ratio (-21%) were statistically significant reduced (all: P<0001). HDLC was not significantly increased (+2%). The body weight (BW) mean change in the group was statistically significant (-22%; P 0.001). Group B: TC (-24%), LDLC (-32%), TG (-29%), nonHDLC (-32%) levels and TC/HDLC (-26%) were significantly decreased (all: P 0.001). HDLC showed a -2.3% not significant decrease. The BW mean change was not statistically significant (-18%). Group C: TC (-36%), LDLC (-51%), nonHDLC (-45%) levels and TC/HDLC (-38%) were significantly decreased (all: P 0.001). HDLC (+4%) was only slightly increased, and TG (-16%) decreased, but the changes were not statistically significant. The BW mean change was not statistically significant (-15%). Group D: TC (-47%), LDLC (-63%), TG (-23%) and nonHDLC (-58%) levels and TC/HDLC (-50%) showed a statistically significant reduction (all: P 0001). HDLC concentration in plasma showed only a slight not significant reduction (- 4%). The BW mean change was statistically significant (-20%; P 0.001). Hyperlipidemia in children can be successfully treated without side effects. The most severe hyperlipidemia is, the most appropriate treatment (diet only,or diet+G, or diet+drugs) is to be given. The reduction of TC/HDLC ratio in childhood prevents future increase of cardiovascular risk in adulthood.
Dyslipidemia in children, dietary and drug treatment in childhood, polygenic and monogenic dyslipidemia, glucomannan, ezetimibe, atorvastatin, cardiovascular risk, overweight in children
University of Rome - Dept. of Molecular Medicine - "Umberto I" Hospital 155, V.le del Policlinico ROME I-00161 (EU), Italy.