Relationship between fat distribution and lipid and apolipoprotein profiles in young teenagers

The influence of obesity and fat distribution on serum levels of lipoprotein and apolipoprotein was investigated in 294 Japanese junior high school children (12-13 years of age). Serum levels of low-density lipoprotein cholesterol (LDLC) (P= 0.013), triglycerides (TG) (P= 0.0006), and apolipoprotein B (apoB) (P= 0.003), and the apoB/A-I ratio (P= 0.005) were significantly higher and serum levels of high-density lipoprotein cholesterol (HDLC) (P= 0.00003) and apoA-1(P = 0.003) were significantly lower in obese boys than in non-obese boys. The serum levels of TG (P = 0.013) and the apoB/A-1 ratio (P= 0.011) were significantly higher and the serum levels of HDLC (P= 0.004) was significantly lower in obese girls than in non-obese girls. The LDLC/apoB ratio was lower in obese girls than in non-obese girls (P= 0.03). Obesity ( 20% of ideal weight) was strongly correlated with the serum levels of lipids and apolipoproteins in boys; this relationship was less clear in girls. The degree of obesity and the body mass index (BMI) were more strongly correlated with serum levels of lipids and apolipoproteins in boys than in girls. In boys, atherogenic-lipoproteins and apolipoproteins, such as LDLC and apoB, showed a stronger correlation with the thickness of the triceps skinfold, while in girls the anti-atherogenic lipoproteins and apolipoproteins, such as HDLC and apoA-1, showed a stronger correlation with both the triceps and the subscapular skinfold thicknesses. In girls the relationships between the BMI and the degree of obesity and the thickness of the subscapular skinfold (S) thickness were similar to the relationships between those parameters and the triceps skinfold (T) thickness. In boys, these parameters showed a stronger correlation with the subscapular skinfold thickness than with the triceps skinfold thickness. The correlation coefficients for the relationships between skinfold thickness and lipid and apolipoprotein levels were similar to the coefficients for the relationships between skinfold thicknesses and the severity of obesity and the BMI. The distribution of central-type fat accumulation, which is indicated by the thickness of the subscapular skinfold, the S/T ratio and S-T value, was inversely correlated with the HDLC level in both boys and girls. The degree of obesity was strongly correlated with the atherogenic lipoprotein profile in boys, in part because the subscapular skinfold thickness was strongly correlated with the degree of obesity and the BMI. In girls, the correlations between indices of central-type obesity and atherogenic lipid and apolipoprotein profiles were stronger than in boys. These data suggest that childhood obesity may be an early cardiovascular risk factor.     

Serum homocysteine and lipoprotein (a) concentrations in hypercholesterolemic and normocholesterolemic children

The relationship between lipids, lipoproteins, total homocysteine, and lipoprotein (a) was studied in hypercholesterolemic and normocholesterolemic children. In hypercholesterolemic children, concentrations of total cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein B, and triglycerides were significantly higher compared to levels in controls, whereas concentrations of high-density lipoprotein (HDL) cholesterol and apolipoprotein A-I were lower compared to those in the control group. Total serum homocysteine concentrations in children with a positive family history for cardiovascular disease CHD(+) (7.28 micromol/L) were significantly higher than those in the control group (5.45 micromol/L), and in the group of CHD(-) children (5.25 micromol/L). The median value of lipoprotein (a) in patients was 31.5 mg/dL (range, 11-209 mg/dL) and in the control group, 19 mg/dL (range, 11-95 mg/dL). Concentrations of Lp (a), exceeding 30 mg/dL, were present in 45% of CHD(+) children, in 29% of CHD(-) children, and in only 11% of the control group.     

Relationship of body mass index with serum lipids in elementary school students

Objective  To determine the relationship of body mass index with serum lipids in elementary students. Methods  This prospective analytic study was conducted among 954 elementary school students (9–11years), selected by multi stage random systematic method from 6 cities and their rural areas from The South Khorasan province (eastern Iran) from September to December 2006. Height and weight was measured and Body mass index was calculated. Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined. Results  954 students 9–11 years old were studied. 45.4% were boys. 76.5% were living in the city. 1.8% of students were obese and 3.4% were over weight. There was no significant relation between obesity and overweight with sex, age and the area of residence. There was significant relation between BMI with TC (P= 0.003), TG (P< 0.001) and LDL-C (P= 0.04). TG was significantly higher in obese and overweight students than in normal weight students (P< 0.001). TC (0.002) and LDL-C (0.01) were significantly higher in obese students than normal weight students. The prevalence of high TG was significantly higher in obese and overweight students than normal weight students (0.003). There was no significant difference between different kinds of dyslipidemia with area of residence. Conclusion  it is necessary to measure serum lipid profile in obese and overweight children.     

Serum lipid profile in obese children in China

BACKGROUND: The aim of the present study was to examine the serum lipid profile in obese Chinese children, their serum lipid and apolipoprotein A-I (apoA-I) and B (apoB) levels were examined. METHODS: The subjects were 153 patients (109 male and 44 female) aged 4-16 years with obesity, who attended the outpatient clinic of Beijing Children's Hospital. Percentage bodyweight (%BW) ([(bodyweight - standard weight)/standard weight]x 100) were obtained. Skinfold thickness and hip and waist circumference were measured. Percentage body fat (%BF) was estimated by bioelectrical impedance analyzer. Serum total cholesterol (TC), high density lipoprotein cholesterol (HDLC), triglyceride (TG), apoA-I and apoB levels were also measured. RESULTS: TC showed an acceptable level in 86.8% of obese children. The prevalence of high TC levels (3.3%) or high LDLC levels (6.0%) was rather low. The HDLC level was reduced in 31.3% of obese children. Anthropometric variables had no linear relationship to TC, HDLC, TG, LDLC, apoA-I or apoB, but in the older age group (over 10 years old) %BW and %BF showed a weak correlation with HDLC (r = -0.202, r = -0.211, respectively). CONCLUSION: In obese Chinese children, HDLC as well as TC levels should be examined in order to assess coronary risk.     

Hereditary dyslipidemias and combined risk factors in children with a family history of premature coronary artery disease.

AIM: Schoolchildren aged 10-11 with a family history of premature coronary artery disease (CAD), were examined in order to identify children with genetically determined dyslipidemias and a combination of risk factors. METHODS: A total of 4000 questionnaires were distributed by the school; 55% of the families answered and returned the questionnaire. Blood lipids, apolipoprotein B, and Lp(a) lipoprotein were analysed in high risk children and their parents. RESULTS: A family history of premature CAD in parents or grandparents was identified in 208 families; 175 agreed to take part in a clinical examination and laboratory tests. Normal blood lipid tests were found in 89 children. Another 48 had an isolated increase of Lp(a) lipoprotein of minor clinical importance. Of the remaining 38 children, 23 had non-hereditary abnormalities of low (LDL) or high density lipoprotein (HDL) cholesterol or apolipoprotein B. Fifteen children were suspected to have genetically determined dyslipidemias or a combination of risk factors: in four, possible familial hypercholesterolaemia (FH); in five, possible familial combined hyperlipidaemia; in three, hereditary low HDL cholesterol; and in three a combination of high LDL cholesterol and Lp(a) lipoprotein concentrations. In addition, possible FH was detected in eight of the parents. CONCLUSION: It is worthwhile asking parents about the occurrence of premature CAD among their child's closest relatives.     

Effects of ketogenic diet on vascular function

BackgroundKetogenic diet is a well-established treatment in children with difficult to treat epilepsy. Very little is known about the long-term effects on vascular atherogenic and biochemical processes of this high-fat and low carbohydrate and protein diet.MethodsWe evaluated 26 children after one year and 13 children after two years of ketogenic diet. High resolution ultrasound-based assessment was used for carotid artery intima-media thickness (cIMT), carotid artery distensibility and carotid artery compliance. Blood lipids including high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol, (LDL-C), total cholesterol (TC), apolipoprotein A (apoA), apolipoprotein B (apoB) and high-sensitivity C-reactive protein (hsCRP) were analysed.ResultsA gradual decrease in carotid distensibility and an increase in LDL-C, apoB and the TC:LDL-C and LDL-C:HDL-C ratios were seen at three and 12 months of KD-treatment. These differences were not significant at 24 months. cIMT, BMI and hsCRP did not show any significant changes.ConclusionsThe initial alterations in lipids, apoB and arterial function observed within the first year of KD-treatment appear to be reversible and not significant after 24 months of treatment.     

Serum lipid and lipoprotein profile in children with iron deficiency anemia

BACKGROUND: A close association has been found between serum lipoprotein abnormalities and the risk of atherosclerosis. In adults, high stored body iron, high serum iron concentrations and low iron binding capacity were found to be risk factors for coronary heart disease. Iron-deficient diets have caused contradictory lipid changes in rats. This report investigates the relationships between iron deficiency, macronutrient intake and the serum lipid and lipoprotein profiles in children with iron deficiency anemia (IDA). METHODS AND RESULTS: Fifty-six children with IDA, aged 3.0 +/- 1.3 years and 60 healthy age- and sex-matched controls were evaluated. The mean total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C), lipoprotein (a) levels and LDL-C/high density lipoprotein cholesterol (HDL-C) and TC/HDL-C ratios of the IDA group were significantly lower than those of controls. While there were no differences in triglycerides and apolipoprotein B (apoB) values between patients and controls, apolipoprotein A-1 (apoA-1) and HDL-C levels were higher in the IDA group. Dietary energy, carbohydrates, total fat and protein intakes of the IDA group were lower than those of controls. After oral iron supplementation, the lipoprotein profile of patients with IDA became similar to controls. In the multivariate analysis, while energy was taken as a covariate, there was no difference in the lipid profile of patients and controls. CONCLUSIONS: Patients with IDA are also deficient in macronutrients. The low atherogenic serum lipid profile of IDA is not a direct result of iron deficiency itself, but related to decreased energy and protein intakes.     

Hereditary dyslipidemias and combined risk factors in children with a family history of premature coronary artery disease

AIM—Schoolchildren aged 10-11 with a family history of premature coronary artery disease (CAD), were examined in order to identify children with genetically determined dyslipidaemias and a combination of risk factors.METHODS—A total of 4000 questionnaires were distributed by the school; 55% of the families answered and returned the questionnaire. Blood lipids, apolipoprotein B, and Lp(a) lipoprotein were analysed in high risk children and their parents.RESULTS—A family history of premature CAD in parents or grandparents was identified in 208 families; 175 agreed to take part in a clinical examination and laboratory tests. Normal blood lipid tests were found in 89 children. Another 48 had an isolated increase of Lp(a) lipoprotein of minor clinical importance. Of the remaining 38 children, 23 had non-hereditary abnormalities of low (LDL) or high density lipoprotein (HDL) cholesterol or apolipoprotein B. Fifteen children were suspected to have genetically determined dyslipidaemias or a combination of risk factors: in four, possible familial hypercholesterolaemia (FH); in five, possible familial combined hyperlipidaemia; in three, hereditary low HDL cholesterol; and in three a combination of high LDL cholesterol and Lp(a) lipoprotein concentrations. In addition, possible FH was detected in eight of the parents.CONCLUSION—It is worthwhile asking parents about the occurrence of premature CAD among their child''s closest relatives.     

The Levels of Serum Low-Density Lipoprotein Cholesterol Using Direct Measurement in Healthy Japanese School Children

This study aimed to investigate the levels of serum low-density lipoprotein cholesterol (LDLC) using direct measurement in healthy Japanese school children. The subjects were 621 children (325 boys and 296 girls) aged 9 to 10 in the 4th grade, and 688 children (334 boys and 354 girls) aged 12 to 13 in the 7th grade. The levels of serum LDLC and high-density lipoprotein cholesterol were measured by direct determination (Cholestest LDL and Cholestest NHDL; Daiichi Pure Chemicals Co., Ltd., Tokyo, Japan). In boys in the 4th grade, the mean, the 75th, the 90th and the 95th percentiles of LDLC levels (mg/dl) were 91.6, 104, 124 and 134, respectively. In girls in the 4th grade, they were 92.8, 108, 122 and 130. In boys in the 7th grade, they were 83.4, 96, 113 and 123. In girls in the 7th grade, they were 93.0, 106, 126 and 137. Serum LDLC levels in boys in the 7th grade were lower than those of other groups. The direct measurement of serum LDLC level is useful for evaluation of dyslipidemia in healthy school children, because the method is applicable to non-fasting serum.     

Serum lipids and apolipoproteins from 1 to 15 years: changes with age and puberty, and relationships with diet, parental cholesterol and family history of ischaemic heart disease

We describe the pattern of change for serum lipids and apolipoproteins from 1 to 15 years of age in a cohort of 128 children, supplemented with 215 children from 11 years of age and 243 at 13 years of age. Total cholesterol (TC) decreased after infancy, increased in early puberty and then decreased to 15 years of age. Reciprocal changes in high (HDLC) and low (LDLC) density lipoprotein cholesterol occurred during each interval, with HDLC increasing from 13 to 15 years in both sexes. The correlation for TC between children of both sexes and mothers and fathers varied from 0.1 to 0.28 at 2-13 years. At 15 years of age the correlation between mothers: daughters increased to 0.31, decreased to 0.19 for fathers: daughters, but no asssociation was present between either parent and their sons. There were no differences in mean lipid values for the sample grouped according to the extent of family history of early ischaemic heart disease (before 60 years of age). There were few significant associations between serum lipids, energy and nutrients. At 15 years of age inverse associations were present between TC and energy, protein, sugar, starch and fibre intakes, and a positive association with total fat intake. Adolescence, apolipoproteins, cholesterol, diet, heredity, ischaemic heart disease, lipoprotein (a), lipoproteins, puberty     

New criteria of normal serum lipid levels in Japanese children: The nationwide study

AIM: To make new criteria of serum lipid levels in current Japanese children using the large nationwide data provided from Japan Association of Health Service for the analysis. METHODS: The subjects were schoolchildren who received screening and care programs for lifestyle related diseases since 1993-1999. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDLC) and triglyceride (TG) levels were measured, and low-density lipoprotein cholesterol (LDLC) levels were calculated. Serum lipid levels were analyzed by age and sex. For each serum lipid, we extracted age- and sex-specific group which the mean value was not statistically different from that in 1999 by Student's t-test analysis. RESULTS: The level below the 75th percentile was defined to be acceptable, from the 75th to 95th to be borderline and over the 95th to be high in TC/LDLC. The level below the fifth percentile in HDLC was defined to be low and the level over the 95th percentile in TG to be high. Therefore, TC level was categorized as follows: acceptable < 190 mg/dL; borderline 190-219 mg/dL; and high > 220 mg/dL. The LDLC level was also categorized into: acceptable < 110 mg/dL; borderline 110-139 mg/dL; and high > 140 mg/dL. The cut-off value in TG was determined to be 140 mg/dL and in HDLC was 40 mg/dL. CONCLUSIONS: This new criteria should prove valuable in health strategies for rational prevention and intervention in children. It should be emphasized to provide some intervention for Japanese children immediately.     

Circulating lipids and glycaemic control in insulin dependent diabetic children

The prevalence of dyslipidaemia in children with insulin dependent diabetes mellitus (IDDM) and its relation to glycaemic control was studied in a group of 51 diabetic children and a control population of 132 schoolchildren. The prevalence of dyslipidaemia in the fasting state was increased in the diabetic group (39%) compared with control subjects (17%). Serum cholesterol concentration alone was raised in 25% of diabetic subjects while serum cholesterol and triglycerides were raised in 14%, compared with 16% and 0.7% respectively in control subjects. Serum total cholesterol (5.1 v 4.5 mmol/l), low density lipoprotein cholesterol (3.2 v 2.6 mmol/l), non-esterified fatty acids (0.91 v 0.50 mmol/l), and triglycerides (0.94 v 0.76 mmol/l) were higher in diabetic children. Serum total cholesterol, triglycerides, and apolipoprotein (apo)B concentrations increased with worsening control, while serum high density lipoprotein cholesterol and apoA-I concentrations were unaltered. There were also positive correlations between glycated haemoglobin and total cholesterol, triglycerides, and apoB in diabetic children. Thus, abnormalities in circulating lipids are common in young subjects with IDDM but largely disappear if blood glucose concentrations are reasonably controlled.     

Circulating lipids and glycaemic control in insulin dependent diabetic children.

The prevalence of dyslipidaemia in children with insulin dependent diabetes mellitus (IDDM) and its relation to glycaemic control was studied in a group of 51 diabetic children and a control population of 132 schoolchildren. The prevalence of dyslipidaemia in the fasting state was increased in the diabetic group (39%) compared with control subjects (17%). Serum cholesterol concentration alone was raised in 25% of diabetic subjects while serum cholesterol and triglycerides were raised in 14%, compared with 16% and 0.7% respectively in control subjects. Serum total cholesterol (5.1 v 4.5 mmol/l), low density lipoprotein cholesterol (3.2 v 2.6 mmol/l), non-esterified fatty acids (0.91 v 0.50 mmol/l), and triglycerides (0.94 v 0.76 mmol/l) were higher in diabetic children. Serum total cholesterol, triglycerides, and apolipoprotein (apo)B concentrations increased with worsening control, while serum high density lipoprotein cholesterol and apoA-I concentrations were unaltered. There were also positive correlations between glycated haemoglobin and total cholesterol, triglycerides, and apoB in diabetic children. Thus, abnormalities in circulating lipids are common in young subjects with IDDM but largely disappear if blood glucose concentrations are reasonably controlled.     

家族性高胆固醇血症并冠心病低密度脂蛋白受体基因突变分析

目的 检测1例家族性高胆固醇血症(FH)并冠心病患儿低密度脂蛋白受体(LDL-R)基因点突变,分析基因型与临床表型间的关系,探讨该病发病的可能分子机制.方法 先证者,女,11岁.以肘、膝、踝关节处有黄色瘤、双眼有明显角膜弓,频发劳累时胸痛为主诉入院.以患儿及其父母的基因组DNA为模板,用降落PCR方法,在同一程序中扩增LDL-R基因的启动子和全部18个外显子;单链构象多态性(SSCP)分析PCR扩增产物,对有异常SSCP带型的PCR产物进行DNA测序;采用PCR-DNA测序技术,检测载脂蛋白apoB100基因Q3500R突变,以排除家族性apoB100缺陷症.结果 该患儿及其母亲第14外显子发生Pro664 →Leu(P664L)杂合错义突变,其父未发现该突变.未检测出患儿及其父母apoB100Q3500R突变.结论 此患儿为LDL-R基因存在P664L杂合错义突变,来自其母;该突变可能是FH的致病突变.     

The effects of long-term anticonvulsive treatment on serum lipid profile

Serum lipids were determined in 10 untreated patients with recently diagnosed epilepsy, 21 patients treated with carbamazepine (CBZ), 10 patients treated with valproate (VPA) and in 15 healthy children. In relation to the controls, patients receiving CBZ showed increased serum high-density lipoprotein cholesterol (HDLc), apolipoprotein A (Apo-A) and apolipoprotein B (Apo-B). Patients receiving VPA showed increased Apo-B levels. There were no significant differences in total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDLc) or very low-density lipoprotein cholesterol (VLDLc) between all groups. The changes in lipid metabolism may be associated with the induction of liver enzymes during anti-epileptic drug metabolism. The CBZ-induced change in serum lipid levels was considered to be a possible factor against atherosclerosis and coronary heart disease in epileptic patients.     

肾病综合征患儿血载脂蛋白E变化及与中分子尿蛋白关系的研究

目的　研究原发性肾病综合征 (INS)患儿血载脂蛋白E(ApoE)的变化及与中分子尿蛋白的关系。 方法　检测 5 0例INS患儿血ApoE及血胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL C)、低密度脂蛋白胆固醇 (LDL C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)及血清总蛋白 (TP)、白蛋白 (Alb)、2 4h尿蛋白 (TUP)。用HYDRASYSLC(Sebia)全自动电泳分析系统测定INS患儿尿蛋白分子质量大小以确定其尿蛋白类型。以 5 0例年龄、性别相匹配的健康儿童为对照组。结果　活动期INS患儿血ApoE及血TC、TG、HDL C、LDL C、ApoB显著高于对照组 (均P <0 0 1)。 92 %INS患儿有高ApoE血症。血ApoE及血TC、TG、LDL C、ApoB与血TP、Alb呈显著负相关 (P <0 0 1) ,而血ApoE、TC、TG、LDL C、ApoB与TUP无相关。选择性中分子蛋白尿 (SMUP)组血ApoE显著高于非选择性蛋白尿 (NSUP)组 (P <0 0 1)。结论　INS患儿血ApoE明显升高 ,高ApoE血症广泛存在于INS患儿 ,血ApoE升高不能作为脂蛋白肾小球病的特异性诊断指标。中分子尿蛋白是INS患儿血ApoE升高的一个重要原因。     

载脂蛋白E基因多态性与原发性肾病综合征脂质代谢紊乱的关系

目的研究原发性肾病综合征(PNS)患儿载脂蛋白E(apoE)主要等位基因和基因型的分布规律,探讨apoE基因多态性与PNS脂质代谢紊乱的关系。方法检测PNS患儿46例和正常小儿39例血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、apoA1、apoB和apoA1/B,同时用聚合酶链反应-单链构象多态性(PCR-SSCP)结合测序的方法确定apoE基因型,并根据平衡法计算出各等位基因频率。结果1.肾病组TC、TG、HDL-C、LDL-C、apoB、apoA1/B均明显高于对照组(P均<0.01);2.肾病组apoE2/2频率显著高于对照组(χ2=4.50 P<0.05);3.肾病组不同基因型和等位基因各项血脂指标均未见明显差异。结论PNS患儿存在明显脂质代谢紊乱,apoE2/2频率显著增高,apoE基因多态性对PNS患儿血脂水平未见明显影响。     

Serum lipid profile in children receiving anti-epileptic drug monotherapy: is it atherogenic?

The effect of anti-epileptic drugs (AEDs) on serum lipid profile is controversial in children as well as in adults. We longitudinally studied serum lipid profile in 34 newly diagnosed epileptic children receiving AED monotherapy with valproic acid (VPA), carbamazepine (CBZ) or phenobarbital (PB). Serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), apolipoprotein Al (Apo A1) and apolipoprotein B (Apo B) were measured at baseline and after 2 years of AED monotherapy. Atherosclerotic indices of TC/ HDL-C and Apo A1/Apo B ratios were calculated. Although there were some alterations in serum lipid profile with AED without statistical significance, the atherosclerotic indices of TC/HDL-C and Apo A1/Apo B ratios did not change significantly after 2 years of monotherapy. Only serum TGs levels significantly decreased with VPA monotherapy. These data suggest that 2 years AED monotherapy with VPA, CBZ or PB did not cause a significant level of concern for an atherogenic effect in children with epilepsy.     

Serum Lipid and Lipoproteins Concentrations in Obese Children as Atherogenic Risk Factors

Nine hundred and ninety-eight obese children aged 6 to 15 years participated in the present study. Fasting serum lipid and lipoprotein cholesterol values were measured and the relationship between obesity and abnormalities of serum lipids and lipoproteins was assessed. The results were as follows: 1. Obese children were more likely than non-obese children to have elevated serum total cholesterol (TC), triglyceride (TG) and LDL-C(low density lipoprotein cholesterol) levels and reduced HDL-C (high density lipoprotein cholestrol) levels. 2. The more the relative body weight index increased, the worse the abnormalities of serum lipids and lipoproteins became. This tendency was marked in junior high-school boys. 3. Hypercholesterolemia in obese children was mostly accounted for by LDL-C only and elevated HDL-C could not be detected.     

Cardiovascular risk factors in children with obesity,hypertension and diabetes: lipoprotein(a) levels and body mass index correlate with family history of cardiovascular disease

The aims of the study were to compare atherosclerosis risk factors in obese, hypertensive and diabetic children with positive and negative family history (FH) of cardiovascular disease (CVD) and to find which of the new atherosclerosis risk factors may be of clinical value in predicting future cardiovascular events. A total of 285 children and adolescents were divided into groups: obese, obese and hypertensive, hypertensive, and diabetic. Each group was further segregated into children with positive or negative FH of CVD. Positive FH groups were analysed according to FH of CVD before or after 55 years of age, and in parents and grandparents separately. We assessed lipids, body mass index (BMI) and new risk factors: lipoprotein(a) Lp(a), apolipoprotein A-I (apo A-I) and apolipoprotein B (apo B), homocysteine (Hcy), fibrinogen (FB), tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1). A positive FH of CVD was found in 28% of the children and in 8.7% it was premature CVD. Children with a positive FH had higher BMI (25.4 versus 23.7 kg/m(2), P<0.05) and highest BMIs were found in those with FH of CVD <55 years (26.8 kg/m(2), P<0.05) or in parents (27.4 kg/m(2), P<0.05). Lp(a) levels were higher in children with a positive FH (0.38 versus 0.28 g/l, P<0.05) and highest in children with a FH of premature CVD (0.44 g/l, P<0.05). Differences were also found in apo B levels (0.90 versus 0.84 g/l, P<0.05). In logistic regression analysis only BMI and Lp(a) were significant in predicting future cardiovascular events. CONCLUSION: obese, hypertensive and diabetic children often originate from families with cardiovascular disease. Children with a family history of cardiovascular disease have a higher body mass index. Levels of lipoprotein(a) and apolipoprotein B may be predictive of future cardiovascular disease in predisposed children.