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Non-traditional risk factors for atherosclerosis in high risk children
L C Blieden1, N Kuberger, R Goez
1Institute of Cardiology, Schneider Children's Medical Center of Israel, Petah Tikva.
Insights
Children with a family history of early heart attack show elevated non-traditional atherosclerosis risk factors. These include insulin resistance, high lipoprotein(a), and autonomic dysfunction, indicating a need for early screening.
Area of Science:
- Pediatrics
- Cardiovascular Medicine
- Metabolic Disorders
Background:
- Atherosclerosis poses a significant risk to cardiovascular health.
- Identifying non-traditional risk factors in pediatric populations is crucial for early intervention.
- Children with a paternal history of myocardial infarction (MI) before age 48 represent a high-risk group.
Purpose of the Study:
- To investigate the prevalence of non-traditional atherosclerosis risk factors in children with a paternal history of early MI.
- To assess various metabolic, hematologic, and autonomic parameters in this high-risk pediatric cohort.
Main Methods:
- Examined children with a paternal history of MI before age 48.
- Assessed non-traditional risk factors: hyperinsulinemia, insulin resistance, lipoprotein(a) [Lp(a)], fibrinogen, cardiovascular hyperreactivity, and autonomic nervous system (ANS) dysfunction.
- Utilized glucose load tests, Lp(a) and lipoprotein analysis, fibrinogen levels, blood pressure and pulse rate measurements, and Holter monitoring.
Main Results:
- Elevated levels of insulin, Lp(a), and fibrinogen were observed in a significant proportion of children.
- Insulin output was higher in obese children.
- Cardiovascular hyperreactivity and ANS dysfunction (sympathetic and parasympathetic patterns) were noted.
- 25 children presented with more than three non-traditional risk factors.
Conclusions:
- Children with a paternal history of early MI exhibit a higher prevalence of non-traditional atherosclerosis risk factors.
- These findings underscore the importance of early screening and lifestyle interventions in high-risk pediatric populations.
- Further research is warranted to elucidate the long-term implications of these risk factors.
Abstract:
Non-traditional risk factors for atherosclerosis were examined in children whose fathers suffered from myocardial infarction up to age 48. Factors examined were hyperinsulinemia, insulin resistance, lipoprotein(a) [Lp(a)], fibrinogen, cardiovascular hyperreactivity, and autonomic nervous system dysfunction. Hyperinsulinemia was present in five cases (9%) and hypoinsulinemia in two. Insulin output following glucose load was significantly higher in obese children compared with controls. There was an increase in Lp(a) alone in 14 cases (24%) and with low density lipoprotein in 6 cases. Increased fibrinogen and positive correlation with insulin abnormality was present in 29% (76% females) (P >0.02). Cardiac hyperreactivity (increased systolic blood pressure) was present in 9% and increased blood pressure and pulse rate in 17%. Holter monitoring pattern was sympathetic in 39% and parasympathetic in 47% of cases. Thus a number of non-traditional risk factors were found to be higher than normal in a relatively large number of children at high risk for atherosclerosis, with 25 children having more than three risk factors.