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Arterial intima-media thickness in children heterozygous for familial hypercholesterolaemia

Albert Wiegman1, Eric de Groot, Barbara A Hutten

  • 1Department of Paediatrics, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands.

Lancet (London, England)
|April 9, 2004
PubMed

Insights

Children with familial hypercholesterolaemia show increased carotid intima-media thickness from age 12. Early lipid-lowering treatment in children may prevent severe cardiovascular disease.

Area of Science:

  • Cardiovascular Medicine
  • Pediatric Endocrinology
  • Clinical Lipidology

Background:

  • Familial hypercholesterolaemia (FH) is a genetic disorder leading to early-onset severe coronary artery disease.
  • The optimal age to initiate lipid-lowering treatment in children with FH is not established.
  • Carotid intima-media thickness (cIMT) is a marker of subclinical atherosclerosis.

Purpose of the Study:

  • To assess subclinical atherosclerosis in children heterozygous for FH compared to unaffected siblings.
  • To identify predictors of cIMT in this pediatric population.

Main Methods:

  • B-mode ultrasound was used to measure carotid intima-media thickness in 201 children with FH and 80 unaffected siblings (ages 8-18).
  • Multivariate analysis was performed to determine predictors of cIMT.

Main Results:

  • Mean combined cIMT was significantly greater in children with FH (0.494 mm) than in unaffected siblings (0.472 mm) (p=0.002).
  • Elevated cIMT was observed from age 12 in children with FH.
  • LDL cholesterol, age, and sex were significant independent predictors of cIMT.

Conclusions:

  • Children with FH exhibit early signs of atherosclerosis, detectable by increased cIMT from age 12.
  • LDL cholesterol is a key determinant of cIMT in pediatric FH.
  • Further clinical studies are warranted to evaluate the long-term safety and efficacy of statin therapy in children with FH.

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