Monitoring the Effects of Hypolipidemic Treatment in Children with Familial Hypercholesterolemia in Poland

Abstract

Familial hypercholesterolemia (FH) is the most common monogenic autosomal dominant disorder. FH results in an increased cardiovascular mortality rate. However, cardiovascular risk control factors enable the avoidance of approximately 80% of strokes and cardiovascular diseases. Therefore, early detection and implementation of lipid-lowering treatment is essential. In the present study, 57 pediatric patients aged 9.57 ± 3.26 years with FH were enrolled in the study. Researchers checked the lipid profile and performed the ultrasound imaging including intima-media thickness (IMT) measurement and echo (e)-tracking in the study group. Patients were treated with a low-cholesterol diet solely or along with pharmacological treatment with statins. Subsequently, patients were monitored for 12 months. The positive results of dietary treatment were observed in 40 patients. The efficacy of 12 months of nutritional therapy along with pharmacological treatment was reported in 27 patients. We observed a significant decrease in the carotid beta index stiffness and an insignificant decrease in the IMT in the group of patients treated with statins. The obtained data show that statin therapy in children with FH allow for the reduction of the degree of atherosclerotic vessel changes.

Lipid disorders in children – an underestimated problem

“…Delay of the treatment can cause future CVD development. There is growing scientific evidence that statin therapy in pediatric patients is safe and effective [ 7 , 26 , 27 ]. Statin therapy may be initiated in children ≥ 10 years of age (except for children with FH, in whom the Forum of Lipid Experts in Poland recommends the use of statins > 8 years of age (accumulating data support lowering of this age even to 6 years), and in children with homozygous FH < 8 years of age with LDL-C concentration > 500 mg/dl (12.9 mmol/l)) [ 10 ].…”

Efficacy and Safety of Statin Treatment in Children with Familial Hypercholesterolemia: Outcomes of 20 Years of Experience

“…However, when data from Greece, where population-based screening was conducted between the 1st and 3rd years of age, were excluded from the analysis, the mean reduction in LDL-C during statin treatment was much greater, i.e., 33.5% [18]. Another study from Poland showed a 34.4% decrease in LDL-C following one-year treatment with rosuvastatin, although at different doses [19].…”

The treatment of heterozygous familial hypercholesterolemia — a local perspective

“…lipid profile). Early lifestyle and pharmacologic intervention improve outcomes even in the paediatric population [5].…”