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Diet therapy for hypercholesterolemia in children and adolescents. A follow-up
M Sanchez-Bayle1, A Gonzalez-Requejo, J Baeza
1Hospital del Niño Jesus, Madrid, Spain.
Objective:
To determine the effectiveness and compliance of dietary restriction in a group of children and adolescents with hypercholesterolemia.
Research Design:
Prospective clinical trial.
Setting:
Pediatric hospital in Madrid, Spain.
Participants:
Four hundred fifty-one children and adolescents of both sexes aged 2 to 18 years diagnosed as having hypercholesterolemia and treated with dietary restriction (American Heart Association Step-One and Step-Two Diets). The follow-up period ranged from 6 months to 2 years and was performed by one pediatrician.
Results:
Total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B-100 levels as well as the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio decreased significantly (P < .01) from the first month of dietary restriction, whereas the high-density lipoprotein cholesterol level increased (P < .01). The apolipoprotein A-I level increased significantly (P < .01) only after 6 months of diet therapy. After 12 months of follow-up, 30.7% (58/189) of patients did not follow the diet strictly. In this group, significantly higher levels of total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B-100 were found.
Conclusions:
Diet therapy is effective in the treatment of hypercholesterolemia in children and adolescents. Dietary restriction has a beneficial effect not only on total cholesterol and low-density lipoprotein cholesterol levels but also on apolipoprotein A-I and B-100 levels.