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Apolipoprotein A-I:B ratio and B screening: a preliminary study of 10- and 11-year-old children
T Sveger1, G Fex, C E Flodmark
1Department of Pediatrics, University of Lund, Malmö General Hospital, Sweden.
Insights
Screening children for abnormal apolipoprotein (apo) A-I:B ratios and apo B levels identified individuals with type IIa hyperlipoproteinemia or hyperapo B lipoproteinemia, including potential familial hypercholesterolemia cases.
Area of Science:
- Pediatric Cardiology
- Clinical Biochemistry
- Genetics
Background:
- Cardiovascular disease risk factors can be identified in childhood.
- Apolipoprotein (apo) profiles, specifically the apo A-I:B ratio and apo B concentration, are key lipid metabolism markers.
- Early detection of dyslipidemias in children is crucial for long-term cardiovascular health.
Purpose of the Study:
- To screen a large cohort of children for abnormal apolipoprotein levels using dried blood spots.
- To identify children with dyslipidemias, including type IIa hyperlipoproteinemia and hyperapo B lipoproteinemia.
- To investigate the familial implications of identified lipid abnormalities.
Main Methods:
- Radial immunodiffusion assay used to measure apolipoprotein A-I:B ratio and apo B concentration in 1,767 children's dried blood spots.
- Children with abnormal screening results (apo A-I:B < 1st percentile or apo B > 99th percentile) were recalled.
- Plasma lipid and apolipoprotein profiles were analyzed in recalled children and their parents.
Main Results:
- Of 17 children recalled for abnormal apo A-I:B ratios, 13 had elevated apo B levels.
- Of 18 children recalled for abnormal apo B levels, 13 had elevated plasma apo B.
- Twenty-three children exhibited abnormal lipid/apolipoprotein concentrations, categorized into type IIa hyperlipoproteinemia (12 children, including 5 likely familial hypercholesterolemia) and hyperapo B lipoproteinemia (11 children, including 4 with potential familial combined hypercholesterolemia).
Conclusions:
- Screening dried blood spots for apolipoprotein levels is effective in identifying children with dyslipidemias.
- Abnormalities detected include type IIa hyperlipoproteinemia and hyperapo B lipoproteinemia, with potential genetic links.
- Further investigation into familial lipid disorders is warranted based on these findings.
Abstract:
The apolipoprotein (apo) A-I:B ratio and the apo B concentration were determined by radial immunodiffusion in dried blood spot samples from 1,767 10- and 11-year-old children. Children with either apo A-I:B ratios below the first percentile or apo B levels above the 99th were recalled and plasma lipid and apolipoprotein profiles were determined for both children and parents. Of 17 children (one family was lost to follow-up) recalled due to abnormal apo A-I:B ratios, apo B levels were above the 95th percentile in 13 children, and of 18 children with abnormal apo B screening levels (three of them also had abnormal apo A-I:B ratios), the plasma apo B level was elevated in 13 children. The 23 children with abnormal blood lipid and/or apolipoprotein concentrations were divided into two main groups: (a) children with type IIa hyperlipoproteinemia and (b) children with hyperapo B lipoproteinemia (hyperapo B) and normal blood lipid levels. Twelve children had the type IIa pattern. Five children likely had familial hypercholesterolemia (FH), the other seven children may have hypercholesterolemia due to obesity or environmental factors. Eleven children had the hyperapo B abnormality. In four children, the elevated apo B level probably was an indication of the occurrence of familial combined hypercholesterolemia (FCH) in the family. Of the remaining seven hyperapo B children, three children also had a parent with hyperapo B and a fourth family suffered from obesity.(ABSTRACT TRUNCATED AT 250 WORDS)