Dyslipidemia in Children With Arterial Ischemic Stroke: Prevalence and Risk Factors

Sultan, Sally; Dowling, Michael M.; Kirton, Adam; deVeber, Gabrielle; Linds, Alexandra; Elkind, Mitchell S.V.; Bernard, Tim; Hernández, Marta; Rivkin, Michael J.; Kopyta, Ilona; Ichord, Rebecca; Benedict, Susan; Mackay, Mark T; Zafeiriou, Dimitrios I.; Troncoso, Mónica; Yager, Jerome Y.; Abraham, Lisa; Lo, Warren; Gonzalez, Veronica D.; Saengpattrachai, Montri; Chan, Anthony; Abdallah, Abdallah; Brankovic-Sreckovic, V.; Kolk, Anneli; Carpenter, Jessica; Kovačević, Gordana; Amlie‐Lefond, Catherine; Steinlin, Maja; Paolicchi, Juliann; Carell, Monroe; Björnson, Bruce; Kosofsky, Barry E.; Wong, Virginia; Pergami, Paola; Friedman, Neil; Yang, Guang; Humphreys, Peter; Nowak‐Göttl, Ulrike; Ferriero, Donna M.; Xavier, Frederico; Fryer, Robert H.; Alveal, Lucila Andrade; Altuna, Diana; Felling, Ryan J.; Pavlakis, Steven G.; Grabowski, Eríc F.; Golomb, Meredith R.; Noetzel, Michael J.; Khoury, Chaouki K.; Lerner, Norma B.; Blair, A. D.; Rafay, Mubeen F.

doi:10.1016/j.pediatrneurol.2017.09.019

Cited by 22 publications

(12 citation statements)

References 37 publications

(44 reference statements)

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“…A study that included children in the International Pediatric Stroke study showed that dyslipidemia was more common in children with arterial ischemic stroke compared to the data from the National Health and Nutrition Examination Survey (NHANES) (38.4% vs. 21%), and that 44.5% of children and 32.9% of adolescents with arterial ischemic stroke had hypertriglyceridemia, suggesting that the prevalence of dyslipidemia, including hypertriglyceridemia, might be higher in children with arterial ischemic stroke than in the general population 24,31…”

Section: Hypertriglyceridemia In Children and Adolescentsmentioning

confidence: 95%

Hypertriglyceridemia in Obese Children and Adolescents

Jung

Yoo

2018

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The increasing prevalence of obesity in children and adolescents is a serious public health concern. Hypertriglyceridemia is common in obese children and adolescents, and elevated triglyceride (TG) level is a known biomarker of cardiometabolic risk. Results from genetic studies suggest that TG and TG-rich lipoproteins and, more specifically, remnant cholesterol are in the causal pathway of cardiovascular disease. However, simultaneous measurement of all remnants has not yet been established, and plasma TG level can be used as a useful marker of remnant cholesterol. Adipose tissue dysfunction, including impaired adipocyte TG storage and release of fatty acids, mediates the development of obesity-related complications. The prevalence of hypertriglyceridemia increases in overweight or obese children and is associated with other cardiometabolic risk factors. Recently, the TG/high-density lipoprotein cholesterol (HDL-C) ratio was recognized as a marker of structural vascular changes and insulin resistance in obese youth. Recent guidelines recommend universal lipid screening with nonfasting non-HDL-C measurement in children at 9–11 years of age; however, fasting lipid profiles should be measured in obese children and overweight adolescents and in those with high non-HDL-C in universal screening. The primary approach to lower TG in children includes dietary and lifestyle modifications; however, children with severe hypertriglyceridemia should also be referred to a pediatric lipid specialist.

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Section: Hypertriglyceridemia In Children and Adolescentsmentioning

confidence: 95%

Hypertriglyceridemia in Obese Children and Adolescents

Jung

Yoo

2018

JOMES

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“…The study by Sarecka-Hujar et al demonstrated that about 40% of children with arterial ischemic stroke had hypertriglyceridemia [ 67 ]. Moreover, the data from the International Pediatric Stroke Study (IPSS) demonstrated that 41% of children with arterial ischemic stroke had elevated levels of TG, whereas 36% of children were dyslipidemic [ 68 ].…”

Section: Resultsmentioning

confidence: 99%

Headache in Children: Selected Factors of Vascular Changes Involved in Underlying Processes of Idiopathic Headaches

et al. 2020

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Headaches are common complaints in children. The International Classification of Headache Disorders, 3rd edition (beta version), defines more than 280 types of headaches. Primary headaches refer to independent conditions that cause pain and include migraine, tension-type headaches (TTH), and trigeminal autonomic cephalalgias (TACs). Several agents are involved in the pathogenesis of headaches. The factors associated with predisposition to atherosclerosis seem to be particularly important from the clinical point of view. The influence of obesity on the incidence of headaches has been well established. Moreover, idiopathic headaches, especially migraine, are thought to be one of the first signs of disorders in lipid metabolism and atherosclerosis. The risk of migraine increases with increasing obesity in children. Another factor that seems to be involved in both obesity and headaches is the adiponectin level. Recent data also suggest new potential risk factors for atherosclerosis and platelet aggregation such as brain-derived neurotrophic factor (BDNF), sCD40L (soluble CD40 ligand), serpin E1/PAI I (endothelial plasminogen activator inhibitor), and vascular endothelial growth factor (VEGF). However, their role is controversial because the results of clinical studies are often inconsistent. This review presents the current knowledge on the potential markers of atherosclerosis and platelet aggregation, which may be associated with primary headaches.

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“…In each patient and healthy subject the status of dyslipidaemia (either TC ≥ 200 mg/dL, or HDL < 40 mg/dL, or non-HDL ≥ 145 mg/dL) and hypertriglyceridemia (for children aged up to 9 years TG ≥ 100 mg/dL, and for children aged 10–19 years, TG ≥ 130 mg/dL) were established following the Sultan et al [ 21 ] recommendations. The following intervals for lipid ratios were used: LDL/HDL normal < 3, borderline 3–4, and high > 4; TC/HDL normal < 4, borderline 4–5, and high > 5; TG/HDL normal < 3, and above normal > 3.…”

Section: Methodsmentioning

confidence: 99%

Levels of Lipid Parameters in Children with Arterial Ischemic Stroke and Headache: Case-Control Study and Meta-Analysis

et al. 2021

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Background: Abnormalities in levels of lipid parameters are one of the main causes of cardiovascular and cerebrovascular disease in adults. There are limited data on the role of disturbances of lipid metabolism in the etiopathogenesis of arterial ischemic stroke (AIS) in children and the results provided are ambiguous. The aim of the study was to compare the levels of lipid parameters (total cholesterol [TC], triglycerides [TG], high-density lipoprotein [HDL] and low-density lipoprotein [LDL]) between children with AIS, children with headache and healthy children. In addition, we performed meta-analysis of available data on lipid parameters in young patients with AIS. Methods: We retrospectively analyzed 218 children hospitalized between 2002 and 2018 in the Upper-Silesian Child’s Health Center (n = 82 children with AIS, n = 45 children with headache, n = 91 healthy children) with available data on lipid levels, i.e., TC, TG, and HDL. The levels of LDL, non-HDL cholesterol, and a very-low density lipoprotein (VLDL) were calculated. The ratios of TC/HDL, TG/HDL and LDL/HDL were also assessed. Data between cases and controls were analyzed using STATISTICA 13.0 whereas meta-analysis was performed with RevMan version 5.4 software. Results: Children with headache were significantly older than children with AIS (p = 0.001). Ten percent of children with AIS had posterior stroke. The mean TC level was significantly higher in the AIS children than in controls or in children with headache. Mean TG and VLDL levels were significantly different between all groups (p < 0.001 each). The hypertriglyceridemia was more prevalent in AIS children than in children with headache (39% vs. 13%, OR = 4.16 95% CI 1.58–10.94, p = 0.004). Similarly, the frequency of dyslipidemia was higher in children with AIS compared to children with headache (38% vs. 22%, OR = 2.13 95% CI 0.93–4.89, p = 0.078). The meta-analysis was conducted based on data from 4 studies (3 studies published previously plus the results we obtained in the present case-control analysis) with total number of 236 young patients with AIS and 272 healthy controls. Significant Standard Mean Difference (SMD) was found in triglycerides level between young patients with AIS and controls (0.78 95%CI 0.30–1.26 p = 0.002). Conclusions: Lipid abnormalities, especially levels of triglycerides, seem to be of particular importance in children with AIS, as confirmed in meta-analysis. The results of the present study may be a significant contribution to the further research on the role of lipid metabolism disorders in the development of childhood stroke.

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Dyslipidemia in Children With Arterial Ischemic Stroke: Prevalence and Risk Factors

Abstract: Dyslipidemia and hypertriglyceridemia may be more prevalent in children with arterial ischemic stroke compared with stroke-free children.

Cited by 22 publications

References 37 publications

Hypertriglyceridemia in Obese Children and Adolescents

Hypertriglyceridemia in Obese Children and Adolescents

Headache in Children: Selected Factors of Vascular Changes Involved in Underlying Processes of Idiopathic Headaches

Levels of Lipid Parameters in Children with Arterial Ischemic Stroke and Headache: Case-Control Study and Meta-Analysis

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