Serum HDL cholesterol and apolipoprotein AI, AII and B levels in Singapore newborns

The mortality from coronary artery disease (CAD) in Indians is more than three times that in the Chinese and Malays of Singapore. Serum total and HDL cholesterol as well as apolipoprotein (Apo) AI, AII and B levels were determined in a group of 349 newborns (cord blood) from both sexes in these three ethnic groups in order to examine if a trend is reflected at birth. Both serum LDL cholesterol and Apo B levels were low in the newborn, while HDL cholesterol and Apo AII levels were almost the same as in adults. Serum Apo AI levels were also low in newborns. No consistent difference as to ethnic group or sex was observed in any of the parameters investigated, except that the females had significantly higher levels of serum Apo AI in all the ethnic groups. Serum total and HDL cholesterol levels in Singapore newborns were comparable to those reported in Caucasians and Asians. The trends of incidence of CAD were not reflected in the lipid profiles studied at birth.     

Serum Total Cholesterol, HDL Cholesterol and Blood Pressure Levels in 15-Year-Old Adolescents in Eastern Finland

ABSTRACT. Serum total cholesterol, HDL-cholesterol and blood pressure were studied among 15-year-old school children in Eastern Finland. The mean serum total cholesterol was 4.47 mmol/l in boys and 4.86 mmol/l in girls; mean HDL-cholesterol was 1.29 mmol/l and 1.46 mmol/l, respectively. The mean blood pressure was 135/65 mmHg in boys and 126/67 mmHg in girls. Obese children had higher blood pressure and lower HDL-cholesterol levels than others. Among boys sexual maturation decreased the HDL-cholesterol level. Children whose parents had histories of cardiovascular disease did not have higher cholesterol or higher blood pressure levels than other children. Children at high risk apparently cannot be screened on the basis of parents' history of cardiovascular diseases.     

Serum total cholesterol and ferritin and blood haemoglobin concentrations in primary schoolchildren

Serum total cholesterol and ferritin and haemoglobin concentrations were measured in blood samples obtained by venepuncture in 378 of 593 children aged 5-6 or 8-9 years from seven primary schools in Canterbury. This study formed part of an investigation to assess the feasibility of including a venepuncture procedure for monitoring purposes in primary schoolchildren. Although only one child had a very low haemoglobin concentration of 61 g/l, a large percentage, 25% in the rising 6 years and 7% in the rising 9 years, had concentrations between 100 and 115 g/l--that is, less than the reference fifth centile. Eight per cent had a serum ferritin concentration less than 8 micrograms/l. Cholesterol concentrations higher than 5.2 mmol/l were found in 20% of the 5-6 year olds and 23% of the 8-9 year olds, and in 19% of boys and 25% of girls. About 5% of children had cholesterol concentrations above 6 mmol/l. The number of children with anaemia, iron deficiency, and high cholesterol raises serious concerns about the nutritional and coronary heart disease risk of British children.     

Serum total cholesterol and ferritin and blood haemoglobin concentrations in primary schoolchildren.

Serum total cholesterol and ferritin and haemoglobin concentrations were measured in blood samples obtained by venepuncture in 378 of 593 children aged 5-6 or 8-9 years from seven primary schools in Canterbury. This study formed part of an investigation to assess the feasibility of including a venepuncture procedure for monitoring purposes in primary schoolchildren. Although only one child had a very low haemoglobin concentration of 61 g/l, a large percentage, 25% in the rising 6 years and 7% in the rising 9 years, had concentrations between 100 and 115 g/l--that is, less than the reference fifth centile. Eight per cent had a serum ferritin concentration less than 8 micrograms/l. Cholesterol concentrations higher than 5.2 mmol/l were found in 20% of the 5-6 year olds and 23% of the 8-9 year olds, and in 19% of boys and 25% of girls. About 5% of children had cholesterol concentrations above 6 mmol/l. The number of children with anaemia, iron deficiency, and high cholesterol raises serious concerns about the nutritional and coronary heart disease risk of British children.     

Tracking of serum total cholesterol during childhood: an 8-year follow-up population-based family study in eastern Finland

AIM: To investigate the tracking of serum total cholesterol (TC) during childhood. METHODS: All children born during 1981-1982 in a rural community of eastern Finland were followed at 6 mo, 7 y and 15 y of age. The full follow-up period was completed by 138 out of 205 children, of whom 82 (33 girls) had TC measured at 7 y and 15 y of age (-7 y, -15 y). The main outcome measurement was TC (mmol/L). RESULTS: TC-7 y was significantly associated with TC-15 y (r = 0.655; p-value < 0.001). This correlation did not change significantly after accounting for confounders. Children in the highest tertile of TC-7 y had a significantly higher risk of being in the highest tertile of TC-15 y compared with children in other tertiles of TC-7 y (relative risk = 6.4 (2.9-13.9)). TC-15 y was predicted positively by TC-7 y (linear regression beta = 0.63; p-value < 0.001) and parental high TC (TC > or = 5.0 mmol/L in at least one parent) (beta = 0.58; p-value = 0.030). Birthweight had no significant association with TC during childhood. CONCLUSION: The study confirmed the tracking of TC during childhood. The identification of children at risk of developing high TC during adolescence should take into consideration the child's previous TC values during childhood and parental TC status.     

Serum total homocysteine concentrations in children and adolescents in Jos, Nigeria

BACKGROUND: Although the elevation of circulating total serum homocysteine (tHcy) concentration in a fasting state is associated with an increased risk of occlusive vascular disease in adults, the levels in children in Nigeria are not known. AIM: The goals of this study were to describe the distribution of tHcy among a representative sample of children and adolescents in Jos, Nigeria, and to test for differences in tHcy among sex and age categories. METHODS: The sampling scheme, which included persons aged 10 to 19 years, was a stratified, multistage probability design. This cross sectional study involved 182 school children drawn from secondary schools in Jos, Nigeria between January and July 2003. Fasting venous samples were collected and assayed for tHcy, Total protein and Albumin. Anthropometric measurements were taken. RESULT: The mean tHcy concentrations were 2.7 +/- 2.4 (95% CI 2.4-2.9), 3.5 +/- 3.2 (3.3-3.8) and 3.6 +/- 3.2 (3.3-4.1), 4.1 +/- 3.6 (4.0-4.4) micromol/l for the girls and boys aged 10-14 and 15-19 years, respectively. Albumin levels correlate positively with plasma total homocysteine, tHcy (r = 0.45, P = 0.03). CONCLUSION: This study provided age-specific data regarding tHcy concentrations between 10-19 years population in Jos, Nigeria. The tHcy concentration increased as a function of age in both sexes.     

Serum lecithin:cholesterol acyltransferase activity, HDL2 and HDL3 composition in hypertensive mothers and their small for gestational age newborns

The aim of this study was to determine serum lecithin:cholesterol acyltransferase (LCAT) activity in parallel with HDL₂ and HDL₃ amounts and composition in pregnancy induced hypertension (PIH) and chronic hypertensive (CH) mothers and in their small for gestational age (SGA) newborns. LCAT activity was assayed by conversion of [³H] cholesterol to labelled cholesteryl ester. HDL₂ and HDL₃ were separated by ultracentrifugation. At term, cholesterol values were similar in PIH, CH and controls. However, higher levels of triglycerides were observed in PIH and CH (+20% and +21%, respectively) as compared with normotensive control mothers (NC). HDL₂ and HDL₃-phospholipids, HDL₂-cholesterol concentrations and LCAT activity were lower in PIH and CH mothers than in NC mothers. Similar changes were also observed in SGA newborns of PHI mothers and in SGA newborns of CH mothers when compared to appropriate for gestational age newborns of control mothers (AGA-NC). In addition, SGA newborns showed low HDL₂ and HDL₃ apoA-I contents. Maternal hypertension and foetal intrauterine growth retardation are associated with profound abnormalities in HDL metabolism, consistent with an atherogenic risk. SGA lipoprotein profiles appear to implicate later metabolic diseases.     

Serum cholesterol levels during and after Kawasaki disease

Serum total cholesterol and high-density lipoprotein (HDL) cholesterol concentrations were studied in paired sera from 23 patients (16 boys) with Kawasaki disease (KD) during acute illness and in 35 patients (21 boys) 5.4 to 7.7 years after KD. Total cholesterol and HDL cholesterol concentrations were significantly lower (paired t test, p = 0.0001) in samples taken within 30 days of the onset of illness (3.32 +/- 0.85 mmol/L (128 +/- 33 mg/dl) and 0.54 +/- 0.25 mmol/L (20.8 +/- 9.7 mg/dl) than in the second samples taken 2 to 16 months after onset of disease (4.16 +/- 0.93 mmol/L (161 +/- 35 mg/dl) and 1.24 +/- 0.35 mmol/L (47.2 +/- 13.9 mg/dl). The lowest total cholesterol levels were observed in samples taken 6 to 9 days after the onset of KD (p = 0.019). No correlations were seen between the highest erythrocyte sedimentation rate, C-reactive protein, or thrombocyte counts and the acute or convalescent cholesterol levels. In patients studied 5.4 to 7.7 years after recovery from KD, the mean total cholesterol concentrations were still lower than in healthy Finnish children. In girls the HDL cholesterol concentrations were similar, whereas 3 of the 18 boys studied had HDL cholesterol values more than 2 SDs below the mean for healthy boys. There was no correlation between the serum cholesterol concentrations and coronary artery abnormalities. These data lead us to infer that KD does not cause such permanent changes in cholesterol metabolism as to be considered a risk factor for atherosclerosis beyond that caused by the disease itself.     

Serum cholesterol and triglyceride levels in Norwegian adolescent school children

The frequency distribution of serum cholesterol and triglycerides in 172 boys and 232 girls, 13--16 years, from four elementary schools in Oslo has been determined. The cholesterol values were significantly higher for girls 15--16 years than for boys of the same age group. In the case of triglycerides boys 15--16 years had significantly higher values than boys 13--14 years. Otherwise no statistically significant differences with regard to sex and age were observed. The 85th percentiles have been suggested as appropriate upper normal limits. In all groups the 85th percentile for plasma cholesterol was slightly below 6 mmol/l. The corresponding plasma triglyceride value was below 2 mmol/l.     

Serum total cholesterol screening for the detection of elevated low-density lipoprotein in children and adolescents: the Bogalusa Heart Study

The use of serum total cholesterol measurement was evaluated as a screening tool to predict elevated levels of low-density lipoprotein cholesterol in 2857 children and adolescents, aged 5 to 17 years, examined in 1981 and 1982. Subjects were from the biracial community of Bogalusa, Louisiana. For selected serum total cholesterol values (150 to 210 mg/dL, 3.88 to 5.43 mmol/L), sensitivities were higher for blacks than whites and higher for females than males, whereas the positive predictive values were higher for whites than blacks and higher for males than females. With the age-, race-, and sex-specific 95th percentiles of serum total cholesterol levels as cutoff points, only 44% to 50% of subjects with elevated low-density lipoprotein cholesterol levels (greater than or equal to 95th percentile) were detected, and approximately 50% of those identified had false-positive results. Lowering the serum total cholesterol cutoff point increased the sensitivity, but decreased the specificity and positive predictive value. At the 75th percentiles of serum total cholesterol levels, sensitivities were 92% to 95% for females and 100% for males and specificities were 78% to 79%, but the false-positive results increased to 81% to 84%. The low cost and ease of obtaining serum total cholesterol measurements contribute to its appeal as a screening tool for hyperlipidemia. However, its poor test characteristics make serum total cholesterol measurement inefficient as a screening tool for detecting elevated levels of low-density lipoprotein cholesterol in children and adolescents.     

Ambulatory blood pressure monitoring in children and adolescents

With recent technological advances, 24-hour ambulatory blood pressure (BP) monitoring (ABPM) has become a useful tool for the evaluation, diagnosis, and management of hypertensive children. It provides a more accurate representation of an individual's BP rather than intermittent casual or office BP measurements. Hence, ABPM is being used more often to assess the BP of children. In this comprehensive review, we provide the reader with the available literature on ABPM, discuss the advantages and limitations of ABPM, and the interpretation of ABPM data. The role of ABPM in various clinical conditions and hypertension research in children is presented.     

Early increases in concentrations of total, LDL, and HDL cholesterol in HIV-infected children following new exposure to antiretroviral therapy

Antiretroviral therapy (ART) is associated with dyslipidemia and cardiovascular disease in adults infected with HIV. For children perinatally infected with HIV, ART exposure is lifelong and early-onset dyslipidemia could have significant long-term effects. We examined cholesterol levels in children during the first year after exposure to a new ART regimen (initiation or switch). In 52 children, total cholesterol increased by 30.5 and 43 mg/dL at 6 and 12 months, respectively (P < 0.001). Low-density lipoprotein cholesterol made the largest contribution, but high-density lipoprotein cholesterol also increased within months of therapy alteration. Early identification of these children and intervention could mediate potential increased risk for future cardiovascular disease.     

Effect of 2 different reducing diets on the concentration of HDL cholesterol in obese adolescents

Serum lipids, lipoproteins, apolipoproteins and fatty acid composition of the major serum lipid classes were determined in fifteen obese adolescents (9 girls and 6 boys, mean age 12.5 +/- 1.2 years, mean overweight 55 +/- 21%) undergoing two weight reduction regimens, differing in fatty acid pattern. The two diets were equal as regards to total energy (approx. 1200 kcal/5100 KJ), protein and carbohydrate content, but differed in the P/S ratio (Diet A: 0.36 +/- 0.19, Diet B, 0.82 +/- 0.44). After eight weeks of treatment with Diet A the patients were switched over to the Diet B. Weight loss during the eight weeks was similar (Diet A: 9.8 +/- 2.1%, Diet B: 7.5 +/- 1.3% reduction of overweight). Diet A resulted in a slight reduction of total and LDL-cholesterol, triglycerides, Apo AI, AII, and B concentrations. HDL-C levels fell significantly from 51 +/- 17 mg/dl to 43 +/- 15 mg/dl (p less than 0.01). Linoleic acid concentrations declined in all major serum lipid classes, in particular in triglycerides and phospholipids (p less than 0.001), whereas arachidonic acid increased in phospholipids (p less than 0.001). After the Diet B a further decline of total cholesterol, LDL-C, triglycerides and Apo B concentrations could be observed, however, HDL-C levels returned to pre-treatment levels (50 +/- 10 mg/dl). Linoleic acid concentrations and arachidonic acid values returned to baseline values. We conclude from this study that in obese adolescents a hypocaloric diet enriched with polyunsaturated fatty acids is associated with a reduction of total-, LDL-C and Apo B concentrations, but with no major changes of HDL-C levels.(ABSTRACT TRUNCATED AT 250 WORDS)