High level of low density lipoprotein cholesterol in younger children of patients with premature coronary artery disease: relation to own and parental risk factors

Abstract

High level of low density lipoprotein cholesterol (LDL-C) is a critical contributor to coronary risk in children of patients with premature coronary artery disease (PCAD). Purpose: To elucidate associations between high LDL-C in children of patients with PCAD (onset ≤55 years, men; ≤60 years, women) and some their own and parental characteristics. Methods: We examined members of 122 families with children aged 5-17 years: 111 parents-probands (83.8% men, aged 32-56 years, 84.7% after MI), their 103 consorts (12.6% men, aged 28-63 years, 1% with overt CAD) and 152 their own children (63.2% men, aged 5-17 years). We registered weight at birth, breast feeding duration, habits, body mass index (BMI), waist circumference (WC), heart rate (HR), systolic (S)/diastolic BP, total/high density lipoprotein (HDL) C, LDL-C, triglycerides (TG), glucose, glucose tolerance, diabetes, arterial pre-/hypertension (NHBPEP-4 criteria) and (in parents) education, menstruation status, metabolic syndrome (MS, JIS criteria). In persons aged 5-17 years high LDL-C was defined as ≥90 percentile (Lipid Research Clinics). Predictors of high LDL-C were selected by age, sex adjusted logistic regression. Results: High LDL-C was found in 42/152 (27.6%) of children. Characteristics related to the presence of high LDL-C with p<0.1 in univariate analysis (BMI, WC, TG, SBP, weight at birth, HDL-C of children; LDL-C, HR, non-smoking of proband; LDL-C, non-smoking of consort) were included into stepwise regression procedure. Independent predictors of high LDL-C were own BMI; LDL-C, HR of proband; LDL-C, non-smoking of consort (table). View this table: Conclusion and interpretation: In this group of children of patients with PCHD high LDL-C was plausibly associated with parental LDL-C and higher own BMI. Lower HR in probands possibly reflected beta blocker use and severety of CAD. Association with nonsmoking of consort supposedly reflected more atherogenic diet in nonsmoking families.