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El aumento de lipoproteínas es un factor de riesgo importante para el tromboembolismo venoso en la infancia
U Nowak-Göttl1, R Junker, M Hartmeier
1Department of Pediatrics, Laboratory Medicine, Westfälische Wilhelms-Universität, Münster, Germany.
Circulation
|August 18, 1999
Resumen
Los niveles elevados de lipoproteína a) [Lp a) ] son un factor de riesgo significativo para el tromboembolismo venoso infantil. La medición de Lp (a) es crucial para la detección de estos eventos en los niños.
Área de la Ciencia:
- Genética cardiovascular Genética cardiovascular Genética cardiovascular Genética cardiovascular Genética cardiovascular
- La trombosis pediátrica en niños.
- El metabolismo de los lípidos.
Sus antecedentes:
- Los niveles de lipoproteína a) [Lp a) ] están determinados genéticamente y están relacionados con la enfermedad aterosclerótica.
- El papel de Lp (a) en las enfermedades tromboembólicas venosas, particularmente en los niños, no está bien caracterizado.
- Los factores de riesgo trombofílicos establecidos incluyen proteínas que regulan la coagulación sanguínea y la fibrinólisis.
Objetivo del estudio:
- Investigar el papel de Lp (a) como factor de riesgo de enfermedades tromboembólicas venosas en niños.
- Evaluar el efecto combinado de Lp (a) y otros factores trombofílicos sobre el riesgo de trombosis venosa.
- Para determinar la relación entre el tamaño de la isoforma de la apolipoproteína (apo) y los niveles de Lp (a) / riesgo tromboembólico.
Principales métodos:
- Se midieron los niveles séricos de Lp(a), lípidos, proteína C, proteína S y antitrombina.
- Apo(a) tamaño de la isoforma y el factor V:Q(506) presencia de mutación fueron analizados.
- Se estudiaron 186 niños con trombosis venosa y 186 controles emparejados (neonatos a 18 años).
Principales resultados:
- Los niños con trombosis venosa tenían niveles medianos de Lp (a) significativamente más altos (19 frente a 4,4 mg/dL).
- Los niveles de Lp> 30 mg/dL confirieron un aumento de 7,2 veces el riesgo de eventos tromboembólicos.
- La mutación del factor V: Q 506, la proteína C y la deficiencia de antitrombina fueron factores de riesgo independientes; un Lp elevado combinado con estos aumentó aún más el riesgo.
Conclusiones:
- La Lp sérica >30 mg/dL es un factor de riesgo significativo para el tromboembolismo venoso en la infancia.
- La medición de la Lp (a) debe ser incorporada en el cribado etiológico de los eventos tromboembólicos venosos pediátricos.
- Apo(a) el tamaño de la isoforma está inversamente relacionado con los niveles de Lp(a) y el riesgo tromboembólico.
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