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Serum cholesterol levels in patients with acute rheumatic fever
M Panamonta1, N Settasatian, E L Kaplan
1Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Thailand.
Insights
Children with acute rheumatic fever (ARF) show abnormal cholesterol metabolism, specifically lower high-density lipoprotein cholesterol and albumin levels. These changes correlate with disease severity, suggesting hepatic dysfunction.
Area of Science:
- Pediatric Rheumatology
- Cardiovascular Metabolism
- Biochemistry
Background:
- Acute rheumatic fever (ARF) is an inflammatory condition affecting children.
- Cholesterol metabolism abnormalities may be linked to ARF and its cardiac complications.
- Understanding these metabolic changes is crucial for managing ARF patients.
Purpose of the Study:
- To investigate cholesterol metabolism abnormalities in children diagnosed with acute rheumatic fever (ARF).
- To correlate these metabolic findings with disease severity, particularly carditis.
Main Methods:
- A cross-sectional and prospective study was conducted in a pediatric ward.
- Serum samples were analyzed from 46 ARF patients, 51 siblings, and 92 controls.
- Measurements included total cholesterol, HDL cholesterol, triglycerides, and liver function tests.
Main Results:
- Children with ARF exhibited significantly lower mean high-density lipoprotein (HDL) cholesterol and albumin levels compared to controls and siblings.
- No significant differences were observed in total cholesterol or triglyceride levels between groups.
- In ARF patients, HDL cholesterol and albumin levels inversely correlated with carditis severity, while triglycerides and alkaline phosphatase correlated positively.
Conclusions:
- This study confirms cholesterol metabolism abnormalities in children with ARF.
- Hepatic dysfunction, potentially related to carditis severity or inflammation, likely explains the observed alterations in HDL cholesterol and triglyceride levels.
Objective:
To determine abnormalities of cholesterol metabolism in children with acute rheumatic fever (ARF).
Design:
Cross-sectional study and prospective study.
Setting:
Pediatric ward of the Khon Kaen (Thailand) University Hospital.
Participants:
Forty-six confirmed patients with ARF (during the acute and recovery phases of disease), 51 siblings, and 92 age- and sex-matched control children.
Interventions:
None.
Measurements/Main Results:
Serum samples of these children were studied for serum total cholesterol, high-density lipoprotein cholesterol, and triglyceride levels and liver function tests. No significant differences were found in mean serum total cholesterol levels (3.68 +/- 0.86 mmol/L [142.4 +/- 33.3 mg/dL] vs 3.75 +/- 0.67 mmol/L [145.0 +/- 25.8 mg/dL], 3.79 +/- 0.75 mmol/L [146.4 +/- 29.0 mg/dL], and 3.80 +/- 0.59 mmol/L [146.9 +/- 23.0 mg/dL]) or mean triglyceride levels (1.19 +/- 0.33 mmol/L vs 1.16 +/- 0.51, 1.12 +/- 0.37, and 1.07 +/- 0.41 mmol/L) (during ARF vs after ARF, sibling, and age- and sex-matched control children, respectively). The children with ARF had significantly lower mean levels of high-density lipoprotein cholesterol and of albumin than did the other groups (analysis of variance, P < .0001). In the ARF group, high-density lipoprotein cholesterol and albumin levels varied inversely with the clinical severity of carditis, while, in contrast, triglyceride and alkaline phosphatase levels varied with the clinical severity of carditis.
Conclusions:
This study confirms abnormalities of cholesterol metabolism in ARF. Hepatic dysfunction associated with the clinically detectable severity of carditis or inflammation might explain the observed differences in serum high-density lipoprotein cholesterol and triglyceride levels in these children.