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Blood rheology and fibrinogen in children with familial hypercholesterolaemia
R H Jay1, S N McCarthy, M W Rampling
1Department of Medicine, University College and Middlesex School of Medicine, Rayne Institute, London, U.K.
Insights
Children with familial hypercholesterolaemia (FH) show no immediate blood flow differences compared to healthy peers. This indicates that early hyperlipidaemia does not directly cause blood rheology changes in young FH patients.
Area of Science:
- Cardiovascular Science
- Pediatric Endocrinology
- Hematology
Background:
- Familial hypercholesterolaemia (FH) is a genetic condition causing high cholesterol levels from birth.
- Adults with FH often exhibit altered blood rheology, including viscosity and red blood cell function.
- The early rheological impact of FH in children remains unclear.
Purpose of the Study:
- To compare rheological parameters in children with heterozygous FH versus age- and sex-matched controls.
- To investigate if hyperlipidaemia in childhood directly affects blood viscosity and red blood cell properties.
Main Methods:
- Compared whole blood and plasma viscosity, red blood cell aggregability and deformability, and plasma fibrinogen.
- Studied 16 children (6-18 years) with heterozygous FH and 16 individually matched healthy controls.
- Measured plasma lipids, including total cholesterol, LDL, HDL, and triglycerides.
Main Results:
- Mean plasma cholesterol (7.19 mmol/l) and LDL cholesterol were significantly higher in FH children compared to controls (4.31 mmol/l).
- Triglycerides and HDL cholesterol levels were similar between the FH and control groups.
- No significant differences were observed in whole blood viscosity, plasma viscosity, red blood cell aggregability, red blood cell deformability, or plasma fibrinogen between the groups.
Conclusions:
- Early-stage heterozygous familial hypercholesterolaemia in children does not appear to cause significant rheological abnormalities.
- The observed rheological changes in adult FH patients may be linked to advanced atherosclerosis rather than solely hyperlipidaemia.
- Further research is needed to understand the long-term rheological consequences of FH in pediatric populations.
Abstract:
Whole blood and plasma viscosity, red cell aggregability and deformability, and plasma fibrinogen have been compared between 16 children aged between 6 and 18 years with heterozygous familial hypercholesterolaemia (FH) and 16 controls individually matched for age and sex. Mean (SD) plasma cholesterol was 7.19 (1.23) mmol/l in the patients and 4.31 (0.84) mmol/l in the controls. This was due to a similar difference in low density lipoprotein (LDL) cholesterol, while triglycerides and high density lipoprotein (HDL) cholesterol were similar between groups. No differences were seen in any of the rheological parameters between the two groups. This suggests that the rheological abnormalities seen in adults with FH are not a direct consequence of their hyperlipidaemia, and may instead be a reflection of their more extensive atherosclerosis.