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Should children with infection be tested for lipid, lipoprotein and apolipoprotein?
1Department of Pediatrics, Faculty of Medicine, University of Celal Bayar, Manisa, Turkey.
Insights
Infection significantly alters lipid profiles in children. Key lipid and apolipoprotein levels decrease during bacterial pharyngitis, suggesting these tests should be avoided during illness.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Biochemistry
- Cardiovascular Health
Background:
- Lipid profiles are known to change during infection.
- Limited research exists on apolipoprotein levels in children experiencing infection.
- Bacterial pharyngitis offers a model to study these changes in healthy children.
Purpose of the Study:
- To investigate changes in serum lipids, lipoproteins, and apolipoproteins in children with bacterial pharyngitis.
- To assess the degree of dyslipidemia associated with this infection.
- To establish whether these markers are reliable during acute illness.
Main Methods:
- Prospective evaluation of 31 children (aged 4-15) hospitalized with bacterial pharyngitis.
- Measurement of serum lipids, lipoproteins, apolipoprotein A-1, apolipoprotein B, and lipoprotein (a).
- Comparison with children's own baseline (self-control) and a control group of 79 healthy children.
Main Results:
- Significant decreases observed in total cholesterol, HDL cholesterol, LDL cholesterol, apolipoprotein A-1, and apolipoprotein B during the symptomatic phase.
- A slight elevation in serum triglyceride levels was noted.
- Serum lipoprotein (a) concentration remained largely unchanged.
Conclusions:
- Transient alterations in serum lipids, lipoproteins, and apolipoproteins occur during infection.
- These findings suggest that assessment of these parameters during infection or inflammation may be unreliable.
- Recommendations are made against routine lipid and apolipoprotein testing during acute illness in children.
Abstract:
The lipid profile is known to alter in patients with infection, but there has not been a study of the apolipoprotein levels in serum of otherwise healthy children during infection. Lipids, lipoproteins, apolipoproteins A-1 and B and lipoprotein (a) were evaluated prospectively in 31 consecutive children, aged 4-15 years, who were admitted to the hospital with bacterial pharyngitis. The degree of dyslipidemia associated with bacterial pharyngitis was assessed using each child as his/her own control and by comparison with 79 healthy children who had not had an infection during the past 3 months. Serum total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A-1 and apolipoprotein B levels were significantly decreased during the symptomatic phase of the disease, whereas the serum triglyceride level was slightly elevated. Serum lipoprotein (a) concentration did not change significantly. In conclusion, it is suggested that serum lipids, lipoproteins and apolipoproteins should not be assessed during infection because of the possible transient changes of these parameters during infection or inflammation.