Statins in children: What do we know and what do we need to do?

Black, Donald M.

doi:10.1007/s11883-001-0007-x

Cited by 12 publications

(7 citation statements)

References 36 publications

(19 reference statements)

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“…In adults with diabetes, fibrates are recommended for hypertriglyceridemia with lower HDL cholesterol (11% in our study) and statins for reducing total and LDL cholesterol (54% in our study) (39). So far, in a limited number of children with familial and severe hypercholesterolemia, statins showed good LDL cholesterollowering efficacy and a low rate of side effects (40). Beyond these effects, statins improve endothelial dysfunction and have antioxidant, antithrombotic, and anti-inflammatory properties that may contribute to their antiatherogenic efficacy (41,42).…”

Section: Frequency Of Pharmacotherapymentioning

confidence: 62%

Spectrum and Prevalence of Atherogenic Risk Factors in 27,358 Children, Adolescents, and Young Adults With Type 1 Diabetes

Schwab

Doerfer²,

Hecker³

et al. 2006

Diabetes Care

230

173

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OBJECTIVE -The aim of this data analysis was to ascertain the type and prevalence rate as well as age and sex distribution of cardiovascular risk factors in type 1 diabetic patients up to 26 years of age.RESEARCH DESIGN AND METHODS -Cardiovascular risk factors such as obesity, hypertension, dyslipidemia, poor glycemic control, and smoking were analyzed in 27,358 patients who were divided into three groups (prepubertal, pubertal, and adult) using specifically designed diabetes software for prospective disease documentation.RESULTS -More than half of the patients per age-group had at least one cardiovascular risk factor. Two risk factors were age dependently found in 6.2-21.7% and three or four risk factors in 0.5-4.7%. Elevated values of HbA 1c , total cholesterol, and BMI were found most frequently. Hypertension, smoking, and HDL cholesterol were observed more frequently in males, and elevated BMI, total cholesterol, and LDL cholesterol more often in females. Although 28.6% of the patients had dyslipidemia, merely 0.4% of them received medical treatment, and of the 8.1% of the patients with hypertension, only 2.1% of them were given antihypertensive medication.CONCLUSIONS -With increasing age, a greater number of patients with cardiovascular risk factors were observed. Significant sex differences were seen in the majority of risk factors. Despite the high prevalence of risk factors, only a small minority of patients received antihypertensive or lipid-lowering treatment. Early identification, prevention, and treatment of additional risk factors seem to be necessary, particularly in light of the high incidence of future cardiovascular disease. Diabetes Care 29:218 -225, 2006T ype 1 diabetes is increasingly recognized as an independent risk factor for premature cardiovascular disease (CVD) and elevated cardiovascular death rate in patients aged 20 -39 years (1). Postmortem studies in children and youth who had died an unnatural death also showed that the development of atherosclerotic lesions of the vessel wall starts in childhood and that there is a close relationship to cardiovascular risk factors. In the Bogalusa Heart Study (2) and the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study (3), the evaluation of premortal existing risk factors (glycohemoglobin Ͼ8%, increased lipids, hypertension, obesity, and smoking) verified their unfavorable influence on the progression of atherosclerosis. Because childhood and adolescence diabetes is commonly associated with additional risk factors (4,5), we conducted this analysis to obtain reliable data about character and prevalence rate as well as age and sex differences of potential atherogenic risk factors in a large population of German children, adolescents, and young adults with type 1 diabetes. RESEARCH DESIGN ANDMETHODS -Based on the continuous diabetes data acquisition system for prospective surveillance (DPV), a crosssectional analysis was carried out to evaluate associated cardiovascular risk factors in patients with type 1 diabetes. The data do...

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Section: Frequency Of Pharmacotherapymentioning

confidence: 62%

Spectrum and Prevalence of Atherogenic Risk Factors in 27,358 Children, Adolescents, and Young Adults With Type 1 Diabetes

Schwab

Doerfer²,

Hecker³

et al. 2006

Diabetes Care

230

173

View full text Add to dashboard Cite

show abstract

“…For example, statins are already used in children, but most studies regarding side effects were carried out in adults. Although in those studies, statins did not only show few side effects but also good LDL cholesterol-lowering effects as well as antiatherogenic effects by improving endothelial function and through their antioxidant, antithrombotic and antiinflammartory properties [2,3,19,25], we actually do not know enough about side effects and long-term medication in childhood and adolescence.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of cardiovascular risk factors in children and adolescents with type 1 diabetes in Austria

et al. 2012

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Mortality of cardiovascular diseases in patients with type 1 diabetes is increased 2- to 20-fold compared to non-diabetic individuals. In young adults with type 1 diabetes, cardiovascular events are more often the cause of premature death than nephropathy. The aim of this study was to evaluate the prevalence and extent of cardiovascular risk factors in children and adolescents with type 1 diabetes in Austria. In a cross sectional study data of children with type 1 diabetes <18 years of age treated at the Children's department of the University Hospitals of Vienna and Graz were collected. We recorded body mass index, waist circumference, blood pressure, HbA1c, triglycerides, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol according to age, sex, age at manifestation, diabetes duration, and insulin requirement. From 264 patients (49.4% male) complete data were available. Of all patients, 76.1% had one or more risk factors, 20.8% had two or more, 10.2% had three or more, and 4.9% had four or more risk factors. Insufficient glycemic control was the most frequent risk factor, present in 60.6% of our patients, followed by elevated triglycerides (22.7%) and increased body mass index (20.1%). Higher prevalence of risk factors was correlated with increasing age, diabetes duration, HbA1c, and insulin requirement. In conclusion, children and adolescents with type 1 diabetes have a much higher prevalence of cardiovascular risk factors compared to non-diabetic individuals. To prevent future cardiovascular events, achieving the best possible glycemic control, early detection of further risk factors, and adequate intervention are highly important.

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“…Children have been studied in a small series of trials with statins, but their use in practice is limited to familial hypercholesterolemia [33]. The completed studies have not indicated any clinically important effects on steroid hormone levels, growth, or maturation.…”

Section: Special Populations To Be Consideredmentioning

confidence: 99%

A general assessment of the safety of HMG CoA reductase inhibitors (statins)

Black¹

2002

Curr Atheroscler Rep

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Few principles in medicine today are as well accepted as the benefits of using statins to reduce cardiovascular risk factors and to prevent cardiovascular disease. The recent withdrawal of a statin (cerivastatin) has lead to a re-examination of all statins, and an attempt to better assess the risk-benefit ratio of this class of drugs. Although the benefits of statin treatment are well known from a myriad of clinical trials, the safety of these compounds has not been an issue since lovastatin was first introduced in 1987. This report provides a brief review of statin safety, and reiterates the excellent profile of this class of drugs.

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Statins in children: What do we know and what do we need to do?

Cited by 12 publications

References 36 publications

Spectrum and Prevalence of Atherogenic Risk Factors in 27,358 Children, Adolescents, and Young Adults With Type 1 Diabetes

Spectrum and Prevalence of Atherogenic Risk Factors in 27,358 Children, Adolescents, and Young Adults With Type 1 Diabetes

Prevalence of cardiovascular risk factors in children and adolescents with type 1 diabetes in Austria

A general assessment of the safety of HMG CoA reductase inhibitors (statins)

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