Hyperlipidemia

Ja, Stewart; McCallin, Tracy; Martínez, Julián; Chacko, Sheebu; Yusuf, Salim

doi:10.1542/pir.2019-0053

Cited by 125 publications

(110 citation statements)

References 34 publications

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“…All biochemical parameters were measured in the morning, on fasting, simultaneously. Normal values of hemoglobin and calciumphosphorus metabolism parameters were taken from the Kidney Disease: Improving Global Outcome (KDIGO) guidelines [17,18], and the normal value of cholesterol and triglycerides from Stewart et al [19]; hyperuricemia was recognized when uric acid was ≥5.5 (mg/dL) [20].…”

Section: Nt-probnp and Biochemical Parametersmentioning

confidence: 99%

NT-proBNP as a Potential Marker of Cardiovascular Damage in Children with Chronic Kidney Disease

Skrzypczyk

Okarska‐Napierała

Pietrzak

et al. 2021

JCM

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Assessing cardiovascular disease (CVD) in children with chronic kidney disease (CKD) is difficult. Great expectations have been associated with biomarkers, including the N-terminal pro-brain natriuretic peptide (NT-proBNP). This study aimed to determine the correlation between NT-proBNP and cardiovascular complications in children with CKD. Serum NT-proBNP, arterial stiffness, common carotid artery intima-media thickness (cIMT), echocardiographic (ECHO) parameters (including tissue Doppler imaging), and biochemical and clinical data were analyzed in 38 pediatric patients with CKD (21 boys, 12.2 ± 4.2 years). Mean NT-proBNP in CKD patients was 1068.1 ± 4630 pg/mL. NT-proBNP above the norm (125 pg/mL) was found in 16 (42.1%) subjects. NT-proBNP correlated with glomerular filtration rate (GFR) (r = −0.423, p = 0.008), and was significantly higher in CKD G5 (glomerular filtration rate grade) patients compared to CKD G2, G3, and G4 children (p = 0.010, p = 0.004, and p = 0.018, respectively). Moreover, NT-proBNP correlated positively with augmentation index (AP/PP: r = 0.451, p = 0.018, P2/P: r = 0.460, p = 0.016), cIMT (r = 0.504, p = 0.020), and E/E’ in ECHO (r = 0.400, p = 0.032). In multivariate analysis, logNT-proBNP was the only significant predictor of cIMT Z-score (beta = 0.402, 95CI (0.082–0.721), p = 0.014) and P2/P1 (beta = 0.130, 95CI (0.082–0.721), p = 0.014). Conclusions: NT-proBNP may serve as a possible marker of thickening of the carotid artery wall in pediatric patients with CKD. The final role of NT-proBNP as a biomarker of arterial damage, left ventricular hypertrophy, or cardiac diastolic dysfunction in CKD children needs confirmation in prospective studies.

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Section: Nt-probnp and Biochemical Parametersmentioning

confidence: 99%

NT-proBNP as a Potential Marker of Cardiovascular Damage in Children with Chronic Kidney Disease

Skrzypczyk

Okarska‐Napierała

Pietrzak

et al. 2021

JCM

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“…For children with an altered lipid profile, the initial management should consist of therapeutic lifestyle changes that focus on dietary modifications, daily physical activity, improving body weight and tobacco smoking cessation [ 21 ]. Moreover, in order to prevent obesity in children, they should be encouraged to sleep for a decent amount of hours per day and to limit screen time (including television, cell phone, computer use, videogames, handheld electronics) to less than 2 h per day.…”

Section: Management Of Dyslipidaemia In Childrenmentioning

confidence: 99%

“…Consultation with a registered nutritionist may help with promoting long-term adherence to a diet; a study of 1062 children (540 children in the intervention group and 522 controls) showed that repeated dietary counselling was helpful in reducing both saturated fat consumption and LDL-C concentrations [ 35 ]. In addition, a paediatric dietitian plays a key role in setting goals, tracking progress, making dietary adjustments and educating parents about nutritional plans inside and outside of the home [ 21 ]. It is important to set realistic short-term dietary goals and to consider social, parental and cultural factors in order to ensure the effective implementation of nutritional changes [ 36 ].…”

Section: Management Of Dyslipidaemia In Childrenmentioning

confidence: 99%

Treatment of Dyslipidaemia in Children

Fiorentino

Chiarelli

2021

Biomedicines

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Childhood dyslipidaemia is one of the main traditional cardiovascular risk factors that initiate and exacerbate the atherosclerotic process. Healthcare providers may play a key role in the management of children with lipid abnormalities; however, they have to properly evaluate the normal lipid values and know the available treatment options in children and adolescents. Current guidelines recommend healthy behaviours as the first-line treatment for childhood dyslipidaemia. The therapeutic lifestyle changes should focus on dietary modifications, daily physical activity, reduction in body weight and tobacco smoking cessation. Parents play a key role in promoting their children’s healthy habits. In children with more severe forms of lipid abnormalities and in those who do not benefit from healthy behaviours, pharmacological therapy should be considered. Safe and effective medications are already available for children and adolescents. Statins represent the first-line pharmacological option, while ezetimibe and bile acid sequestrants are usually used as second-line drugs. Despite their limited use in children, other lipid-lowering agents (already approved for adults) are currently available or under study for certain categories of paediatric patients (e.g., familial hypercholesterolemia). Further studies are needed to evaluate the long-term efficacy, safety and tolerability of novel lipid-lowering drugs, especially in children.

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“…Cascade Screening occurs when screening of one patient results in a diagnosis that requires screening of additional family members for that same diagnosis. Following the diagnosis of FH at the proband, it is essential to examine additional family members for FH [ 14 ]. Current recommendations suggest that screening for FH should be completed in first- and second-degree relatives of the patient.…”

Section: Cascade Screening—testing Of Familiesmentioning

confidence: 99%

Current Approach to the Diagnosis and Treatment of Heterozygote and Homozygous FH Children and Adolescents

Cohen

Stefanutti²

2021

Curr Atheroscler Rep

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Purpose of Review To elucidate the current approach of care in pediatric patients with familial hypercholesterolemia (FH). We sought an answer to the question whether the advances and major changes in lipid management are relevant and apply to children and adolescents. Recent Findings Latest research findings clearly demonstrate that lowering cholesterol levels at a young age prevents vascular atherosclerotic changes and decreases cardiovascular events in adulthood and emphasizes the importance of early detection and intervention in the pediatric FH patients group. Summary FH is a common genetic disease caused by mutations in genes associated with the metabolism of low-density lipoproteins (LDL). The hallmark of FH is elevated LDL cholesterol (LDL-C) levels from birth and premature atherosclerotic cardiovascular disease (ASCVD). Often FH is either undiagnosed or diagnosed with a considerable delay, leading to vascular atherosclerotic changes and cardiovascular disease. Prompt identification of FH subjects is essential, to initiate early preventive measures. Safe and efficient pharmacological agents are approved for use in children and adolescents. Statins are the first line of therapy, in combination of ezetimibe. Unfortunately, these drugs do not warrant the achievement of therapeutic target, especially in HoFH patient. In the latter, lipoprotein apheresis (LA), which has been shown to be safe and effective, is strongly recommended. Finally, the new drugs still under study will allow a multimodal customized treatment. Lowering cholesterol levels at a young age hinders vascular atherosclerotic changes decreasing cardiovascular events in adulthood. Therefore, early detection, diagnosis, and intervention in FH patients are priority objectives.

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Hyperlipidemia

Cited by 125 publications

References 34 publications

NT-proBNP as a Potential Marker of Cardiovascular Damage in Children with Chronic Kidney Disease

NT-proBNP as a Potential Marker of Cardiovascular Damage in Children with Chronic Kidney Disease

Treatment of Dyslipidaemia in Children

Current Approach to the Diagnosis and Treatment of Heterozygote and Homozygous FH Children and Adolescents

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