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Rallidis LS, Rizos CV, Papathanasiou KA, Liamis G, Skoumas I, Garoufi A, Kolovou G, Tziomalos K, Skalidis E, Kotsis V, Sfikas G, Doumas M, Anagnostis P, Lambadiari V, Giannakopoulou V, Kiouri E, Anastasiou G, Petkou E, Koutagiar I, Attilakos A, Kolovou V, Zacharis E, Antza C, Koumaras C, Boutari C, Liberopoulos E. Physical signs and atherosclerotic cardiovascular disease in familial hypercholesterolemia: the HELLAS-FH Registry. J Cardiovasc Med (Hagerstown) 2024; 25:370-378. [PMID: 38526957 DOI: 10.2459/jcm.0000000000001612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
AIMS Three physical signs, namely tendon xanthomas, corneal arcus and xanthelasma, have been associated with heterozygous familial hypercholesterolemia (heFH). The prevalence and clinical significance of these signs are not well established among contemporary heFH individuals. This study explored the frequency as well as the association of these physical signs with prevalent atherosclerotic cardiovascular disease (ASCVD) in heFH individuals. METHODS Data from the Hellenic Familial Hypercholesterolemia Registry were applied for this analysis. The diagnosis of heFH was based on the Dutch Lipid Clinic Network Score. Multivariate logistic regression analysis was conducted to examine the association of heFH-related physical signs with prevalent ASCVD. RESULTS Adult patients ( n = 2156, mean age 50 ± 15 years, 47.7% women) were included in this analysis. Among them, 14.5% had at least one heFH-related physical sign present. The prevalence of corneal arcus before the age of 45 years was 6.6%, tendon xanthomas 5.3%, and xanthelasmas 5.8%. Among physical signs, only the presence of corneal arcus before the age of 45 years was independently associated with the presence of premature coronary artery disease (CAD). No association of any physical sign with total CAD, stroke or peripheral artery disease was found. Patients with physical signs were more likely to receive higher intensity statin therapy and dual lipid-lowering therapy, but only a minority reached optimal lipid targets. CONCLUSION The prevalence of physical signs is relatively low in contemporary heFH patients. The presence of corneal arcus before the age of 45 years is independently associated with premature CAD.
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Affiliation(s)
- Loukianos S Rallidis
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens
| | - Christos V Rizos
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina
| | - Konstantinos A Papathanasiou
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens
| | - George Liamis
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina
| | - Ioannis Skoumas
- 1 Cardiology Department of Athens Medical School, University of Athens, Hippokration Hospital, Athens
| | - Anastasia Garoufi
- Second Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, General Children's Hospital 'P. & A. Kyriakou', Athens
| | - Genovefa Kolovou
- Cardiometabolic Center, Lipid Clinic, LA apheresis Unit, Metropolitan Hospital, Athens
| | - Konstantinos Tziomalos
- 1 Propaedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki
| | | | - Vasileios Kotsis
- 3 Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki
| | - George Sfikas
- Department of Internal Medicine, 424 General Military Training Hospital, Thessaloniki
| | - Michalis Doumas
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki
| | | | - Vaia Lambadiari
- 2 Propaedeutic Internal Medicine Department and Diabetes Research Unit, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens
| | | | - Estela Kiouri
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens
| | - Georgia Anastasiou
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina
| | - Ermioni Petkou
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina
| | - Iosif Koutagiar
- 1 Cardiology Department of Athens Medical School, University of Athens, Hippokration Hospital, Athens
| | - Achilleas Attilakos
- Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, C' Pediatrics Clinic, Attikon University General Hospital, Athens
| | - Vana Kolovou
- Cardiometabolic Center, Lipid Clinic, LA apheresis Unit, Metropolitan Hospital, Athens
| | | | - Christina Antza
- 3 Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki
| | - Charalambos Koumaras
- Department of Internal Medicine, 424 General Military Training Hospital, Thessaloniki
| | - Chrysoula Boutari
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki
| | - Evangelos Liberopoulos
- 1 Propaedeutic Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko Hospital, Athens, Greece
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Katsiki N, Filippatos T, Vlachopoulos C, Panagiotakos D, Milionis H, Tselepis A, Garoufi A, Rallidis L, Richter D, Nomikos T, Kolovou G, Kypreos K, Chrysohoou C, Tziomalos K, Skoumas I, Koutagiar I, Attilakos A, Papagianni M, Boutari C, Kotsis V, Pitsavos C, Elisaf M, Tsioufis K, Liberopoulos E. Executive summary of the Hellenic Atherosclerosis Society guidelines for the diagnosis and treatment of dyslipidemias - 2023. Atheroscler Plus 2024; 55:74-92. [PMID: 38425675 PMCID: PMC10901915 DOI: 10.1016/j.athplu.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/20/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains the main cause of death worldwide, and thus its prevention, early diagnosis and treatment is of paramount importance. Dyslipidemia represents a major ASCVD risk factor that should be adequately managed at different clinical settings. 2023 guidelines of the Hellenic Atherosclerosis Society focus on the assessment of ASCVD risk, laboratory evaluation of dyslipidemias, new and emerging lipid-lowering drugs, as well as diagnosis and treatment of lipid disorders in women, the elderly and in patients with familial hypercholesterolemia, acute coronary syndromes, heart failure, stroke, chronic kidney disease, diabetes, autoimmune diseases, and non-alcoholic fatty liver disease. Statin intolerance is also discussed.
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Affiliation(s)
- N Katsiki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Td Filippatos
- Department of Internal Medicine, School of Medicine, University of Crete, Crete, Greece
| | - C Vlachopoulos
- Cardiology Department, First Cardiology Clinic, Athens Medical School, Hippokration Hospital, Athens, Greece
| | - D Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece
| | - H Milionis
- Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - A Tselepis
- Atherothrombosis Research Centre, University of Ioannina, Ioannina, Greece
| | - A Garoufi
- 2nd Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - L Rallidis
- 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece
| | - D Richter
- Head of Cardiac Department, Euroclinic Hospital, Athens, Greece
| | - T Nomikos
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece
| | - G Kolovou
- Metropolitan Hospital, Cardiometabolic Center, Lipoprotein Apheresis and Lipid Disorders Clinic, Athens, Greece
| | - K Kypreos
- School of Medicine, European University Cyprus, Nicosia, Cyprus
- University of Patras, School of Health Science, Department of Medicine, Pharmacology Laboratory, Patras, 26500, Greece
| | - C Chrysohoou
- 1st Cardiology Clinic National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - K Tziomalos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - I Skoumas
- 1st Department of Cardiology, National & Kapodistrian University of Athens, Athens, Greece
| | - I Koutagiar
- 1st Cardiology Department, Hygeia Hospital, Athens, Greece
| | - A Attilakos
- 3rd Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Attikon General Hospital, Athens, Greece
| | - M Papagianni
- Third Department of Pediatrics, Aristotle University of Thessaloniki, School of Medicine, “Hippokrateion" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - C Boutari
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - V Kotsis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University Thessaloniki, Greece
| | - C Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Greece
| | - M Elisaf
- Department of Internal Medicine, Faculty of Medicine, University Hospital of Ioannina, 45110, Ioannina, Greece
| | - K Tsioufis
- 1st Department of Cardiology, National and Kapodistrian University of Athens, Hippocration Hospital, Greece
| | - E Liberopoulos
- 1st Department of Propedeutic Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
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Barkas F, Rizos CV, Liamis G, Skoumas I, Garoufi A, Rallidis L, Kolovou G, Tziomalos K, Skalidis E, Sfikas G, Kotsis V, Doumas M, Anagnostis P, Lambadiari V, Anastasiou G, Koutagiar I, Attilakos A, Kiouri E, Kolovou V, Polychronopoulos G, Koutsogianni AD, Zacharis E, Koumaras C, Antza C, Boutari C, Liberopoulos E. Obesity and atherosclerotic cardiovascular disease in adults with heterozygous familial hypercholesterolemia: An analysis from HELLAS-FH registry. J Clin Lipidol 2024:S1933-2874(24)00005-9. [PMID: 38331687 DOI: 10.1016/j.jacl.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 12/26/2023] [Accepted: 01/20/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) and obesity are well-established risk factors of atherosclerotic cardiovascular disease (ASCVD). Despite high prevalence, their joint association with ASCVD remains largely unknown. OBJECTIVE To investigate the association of obesity with prevalent ASCVD in individuals with heterozygous FH (HeFH) enrolled in the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH). METHODS FH diagnosis was based on Dutch Lipid Clinic Network (DLCN) criteria. Adults with at least possible FH diagnosis (DLCN score ≥3) and available body mass index (BMI) values were included. Homozygous FH individuals were excluded. RESULTS 1655 HeFH adults (mean age 51.0 ± 14.4 years, 48.6% female) were included; 378 (22.8%) and 430 (26.0%) were diagnosed with probable and definite FH, respectively. Furthermore, 371 participants (22.4%) had obesity and 761 (46.0%) were overweight. Prevalence of ASCVD risk factors increased progressively with BMI. Prevalence of coronary artery disease (CAD) was 23.4% (3.2% for stroke and 2.7% for peripheral artery disease, PAD), and increased progressively across BMI groups. After adjusting for traditional ASCVD risk factors and lipid-lowering medication, individuals with obesity had higher odds of established CAD (OR: 1.54, 95% CI: 1.04-2.27, p = 0.036) as well as premature CAD (OR: 1.74, 95% CI: 1.17-2.60, p = 0.009) compared with those with normal BMI. No association was found with stroke or PAD. CONCLUSIONS Over half of adults with HeFH have overweight or obesity. Obesity was independently associated with increased prevalence of CAD in this population.
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Affiliation(s)
- Fotios Barkas
- Department of Hygiene & Epidemiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece (Dr Barkas); Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece (Drs Rizos, Liamis, Anastasiou, Zacharis)
| | - Christos V Rizos
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece (Drs Rizos, Liamis, Anastasiou, Zacharis)
| | - George Liamis
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece (Drs Rizos, Liamis, Anastasiou, Zacharis)
| | - Ioannis Skoumas
- Cardiology Clinic, Hippokration General Hospital, Athens, Greece (Drs Skoumas and Koutagiar)
| | - Anastasia Garoufi
- 2nd Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece (Dr Garoufi)
| | - Loukianos Rallidis
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece (Drs Rallidis and Kiouri)
| | - Genovefa Kolovou
- Cardiometabolic Centre, Lipid Clinic, LA apheresis Unit, Metropolitan Hospital, Athens, Greece (Dr Kolovou)
| | - Konstantinos Tziomalos
- 1st Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece (Drs Tziomalos and Polychronopoulos)
| | - Emmanouil Skalidis
- Cardiology Clinic, University General Hospital of Heraklion, Heraklion, Greece (Drs Skalidis and Zacharis)
| | - George Sfikas
- Department of Internal Medicine, 424 General Military Training Hospital, Thessaloniki, Greece (Drs Sfikas and Koumaras)
| | - Vasilios Kotsis
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital Thessaloniki, Thessaloniki, Greece (Drs Kotsis and Antza)
| | - Michalis Doumas
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece (Drs Doumas and Boutari)
| | - Panagiotis Anagnostis
- Department of Endocrinology, Police Medical Centre, Thessaloniki, Greece (Dr Anagnostis)
| | - Vaia Lambadiari
- 2nd Propaedeutic Internal Medicine Department and Diabetes Research Unit, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece (Dr Lambadiari)
| | - Georgia Anastasiou
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece (Drs Rizos, Liamis, Anastasiou, Zacharis)
| | - Iosif Koutagiar
- Cardiology Clinic, Hippokration General Hospital, Athens, Greece (Drs Skoumas and Koutagiar)
| | - Achilleas Attilakos
- Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, C' Pediatrics Clinic, Attikon University General Hospital, Athens, Greece (Dr Attilakos)
| | - Estela Kiouri
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece (Drs Rallidis and Kiouri)
| | - Vana Kolovou
- Cardiometabolic Centre, Lipid Clinic, LA apheresis Unit, Metropolitan Hospital, Athens, Greece (Dr Kolovou)
| | - Georgios Polychronopoulos
- 1st Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece (Drs Tziomalos and Polychronopoulos)
| | - Amalia-Despoina Koutsogianni
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece (Drs Rizos, Liamis, Anastasiou, Zacharis)
| | - Evangelos Zacharis
- Cardiology Clinic, University General Hospital of Heraklion, Heraklion, Greece (Drs Skalidis and Zacharis)
| | - Charalambos Koumaras
- Department of Internal Medicine, 424 General Military Training Hospital, Thessaloniki, Greece (Drs Sfikas and Koumaras)
| | - Christina Antza
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital Thessaloniki, Thessaloniki, Greece (Drs Kotsis and Antza)
| | - Chrysoula Boutari
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece (Drs Doumas and Boutari)
| | - Evangelos Liberopoulos
- 1st Propedeutic Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital of Athens, Athens, Greece (Dr Liberopoulos).
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Soldatou A, Garoufi A. Editorial: Pediatric obesity: how to diverge from developmental pathways? Front Endocrinol (Lausanne) 2024; 15:1363099. [PMID: 38323111 PMCID: PMC10844501 DOI: 10.3389/fendo.2024.1363099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024] Open
Affiliation(s)
- Alexandra Soldatou
- 2 Department of Pediatrics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Anastasia Garoufi
- National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Antza C, Rizos CV, Kotsis V, Liamis G, Skoumas I, Rallidis L, Garoufi A, Kolovou G, Tziomalos K, Skalidis E, Sfikas G, Doumas M, Lambadiari V, Anagnostis P, Stamatelopoulos K, Anastasiou G, Koutagiar I, Kiouri E, Kolovou V, Polychronopoulos G, Zacharis E, Koumaras C, Boutari C, Milionis H, Liberopoulos E. Familial Hypercholesterolemia in the Elderly: An Analysis of Clinical Profile and Atherosclerotic Cardiovascular Disease Burden from the Hellas-FH Registry. Biomedicines 2024; 12:231. [PMID: 38275402 PMCID: PMC10813545 DOI: 10.3390/biomedicines12010231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/23/2023] [Accepted: 01/10/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Familial hypercholesterolemia (FH) carries a high risk of atherosclerotic cardiovascular disease (ASCVD). As the population ages, the age-related influence on clinical characteristics and outcomes becomes increasingly pertinent. This cross-sectional analysis from the HELLAS-FH registry aims to explore potential differences in clinical characteristics, treatment, ASCVD, and goal achievement between those younger and older than 65 years with FH. RESULTS A total of 2273 adults with heterozygous FH (51.4% males) were studied. Elderly FH patients (n = 349) had a higher prevalence of ASCVD risk factors, such as hypertension (52.1% vs. 20.9%, p < 0.05) and type 2 diabetes (16.9% vs. 6.0%, p < 0.05), compared to younger patients (n = 1924). They also had a higher prevalence of established ASCVD (38.4% vs. 23.1%, p < 0.001), particularly CAD (33.0% vs. 20.2%, p < 0.001), even after adjusting for major ASCVD risk factors. Elderly patients were more frequently and intensively receiving lipid-lowering treatment than younger ones. Although post-treatment LDL-C levels were lower in elderly than younger patients (125 vs. 146 mg/dL, p < 0.05), both groups had similar attainment of the LDL-C target (3.7% vs. 3.0%). CONCLUSIONS Elderly FH patients have a higher prevalence of ASCVD, particularly CAD. Despite more aggressive treatment, the achievement of LDL-C targets remains very poor. These results emphasize the importance of early FH diagnosis and treatment in reducing ASCVD.
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Affiliation(s)
- Christina Antza
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Christos V Rizos
- Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
| | - Vasileios Kotsis
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - George Liamis
- Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
| | - Ioannis Skoumas
- Cardiology Clinic, Hippokration General Hospital, 54643 Athens, Greece
| | - Loukianos Rallidis
- Department of Cardiology, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anastasia Garoufi
- Second Department of Pediatrics, General Children's Hospital "P. & A. Kyriakou", Medical School, National and Kapodistrian University of Athens, 15452 Athens, Greece
| | - Genovefa Kolovou
- Cardiometabolic Center, Lipid Clinic, LA Apheresis Unit, Metropolitan Hospital, 15562 Athens, Greece
| | - Konstantinos Tziomalos
- 1st Propedeutic Department of Internal Medicine, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Emmanouil Skalidis
- Cardiology Clinic, University General Hospital of Heraklion, 70013 Heraklion, Greece
| | - George Sfikas
- Department of Internal Medicine, 424 General Military Training Hospital, 56429 Thessaloniki, Greece
| | - Michalis Doumas
- Department of Internal Medicine, Hippokration General Hospital, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Vaia Lambadiari
- 2nd Propaedeutic Internal Medicine Department, Diabetes Research Unit, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | | | - Kimon Stamatelopoulos
- Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Georgia Anastasiou
- Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
| | - Iosif Koutagiar
- Cardiology Clinic, Hippokration General Hospital, 54643 Athens, Greece
| | - Estela Kiouri
- Department of Cardiology, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Vana Kolovou
- Cardiometabolic Center, Lipid Clinic, LA Apheresis Unit, Metropolitan Hospital, 15562 Athens, Greece
| | - Georgios Polychronopoulos
- 1st Propedeutic Department of Internal Medicine, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Evangelos Zacharis
- Cardiology Clinic, University General Hospital of Heraklion, 70013 Heraklion, Greece
| | - Charalambos Koumaras
- Department of Internal Medicine, 424 General Military Training Hospital, 56429 Thessaloniki, Greece
| | - Chrysoula Boutari
- Department of Internal Medicine, Hippokration General Hospital, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Haralampos Milionis
- Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
| | - Evangelos Liberopoulos
- 1st Propaedeutic Department of Medicine, Laiko Hospital, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece
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Dharmayat KI, Vallejo-Vaz AJ, Stevens CA, Brandts JM, Lyons AR, Groselj U, Abifadel M, Aguilar-Salinas CA, Alhabib K, Alkhnifsawi M, Almahmeed W, Alnouri F, Alonso R, Al-Rasadi K, Ashavaid TF, Banach M, Béliard S, Binder C, Bourbon M, Chlebus K, Corral P, Cruz D, Descamps OS, Drogari E, Durst R, Ezhov MV, Genest J, Harada-Shiba M, Holven KB, Humphries SE, Khovidhunkit W, Lalic K, Laufs U, Liberopoulos E, Roeters van Lennep J, Lima-Martinez MM, Lin J, Maher V, März W, Miserez AR, Mitchenko O, Nawawi H, Panayiotou AG, Paragh G, Postadzhiyan A, Reda A, Reiner Ž, Reyes X, Sadiq F, Sahebkar A, Schunkert H, Shek AB, Stroes E, Su TC, Subramaniam T, Susekov A, Vázquez Cárdenas A, Huong Truong T, Tselepis AD, Vohnout B, Wang L, Yamashita S, Al-Sarraf A, Al-Sayed N, Davletov K, Dwiputra B, Gaita D, Kayikcioglu M, Latkovskis G, Marais AD, Thushara Matthias A, Mirrakhimov E, Nordestgaard BG, Petrulioniene Z, Pojskic B, Sadoh W, Tilney M, Tomlinson B, Tybjærg-Hansen A, Viigimaa M, Catapano AL, Freiberger T, Hovingh GK, Mata P, Soran H, Raal F, Watts GF, Schreier L, Bañares V, Greber-Platzer S, Baumgartner-Kaut M, de Gier C, Dieplinger H, Höllerl F, Innerhofer R, Karall D, Lischka J, Ludvik B, Mäser M, Scholl-Bürgi S, Thajer A, Toplak H, Demeure F, Mertens A, Balligand JL, Stephenne X, Sokal E, Petrov I, Goudev A, Nikolov F, Tisheva S, Yotov Y, Tzvetkov I, Hegele RA, Gaudet D, Brunham L, Ruel I, McCrindle B, Cuevas A, Perica D, Symeonides P, Trogkanis E, Kostis A, Ioannou A, Mouzarou A, Georgiou A, Stylianou A, Miltiadous G, Iacovides P, Deltas C, Vrablik M, Urbanova Z, Jesina P, Tichy L, Hyanek J, Dvorakova J, Cepova J, Sykora J, Buresova K, Pipek M, Pistkova E, Bartkova I, S|ulakova A, Toukalkova L, Spenerova M, Maly J, Benn M, Bendary A, Elbahry A, Ferrières J, Ferrieres D, Peretti N, Bruckert E, Gallo A, Valero R, Mourre F, Aouchiche K, Reynaud R, Tounian P, Lemale J, Boccara F, Moulin P, Charrières S, Di Filippo M, Cariou B, Paillard F, Dourmap C, Pradignac A, Verges B, Simoneau I, Farnier M, Cottin Y, Yelnik C, Hankard R, Schiele F, Durlach V, Sultan A, Carrié A, Rabès JP, Sanin V, Schmieder R, Ates S, Rizos CV, Skoumas I, Tziomalos K, Rallidis L, Kotsis V, Doumas M, Skalidis E, Kolovou G, Kolovou V, Garoufi A, Koutagiar I, Polychronopoulos G, Kiouri E, Antza C, Zacharis E, Attilakos A, Sfikas G, Koumaras C, Anagnostis P, Anastasiou G, Liamis G, Adamidis PS, Milionis H, Lambadiari V, Stabouli S, Filippatos T, Mollaki V, Tsaroumi A, Lamari F, Proyias P, Harangi M, Reddy LL, Shah SAV, Ponde CK, Dalal JJ, Sawhney JP, Verma IC, Hosseini S, Jamialahmadi T, Alareedh M, Shaghee F, Rhadi SH, Abduljalal M, Alfil S, Kareem H, Cohen H, Leitersdorf E, Schurr D, Shpitzen S, Arca M, Averna M, Bertolini S, Calandra S, Tarugi P, Casula M, Galimberti F, Gazzotti M, Olmastroni E, Sarzani R, Ferri C, Repetti E, Giorgino F, Suppressa P, Bossi AC, Borghi C, Muntoni S, Cipollone F, Scicali R, Pujia A, Passaro A, Berteotti M, Pecchioli V, Pisciotta L, Mandraffino G, Pellegatta F, Mombelli G, Branchi A, Fiorenza AM, Pederiva C, Werba JP, Parati G, Nascimbeni F, Iughetti L, Fortunato G, Cavallaro R, Iannuzzo G, Calabrò P, Cefalù AB, Capra ME, Zambon A, Pirro M, Sbrana F, Trenti C, Minicocci I, Federici M, Del Ben M, Buonuomo PS, Moffa S, Pipolo A, Citroni N, Guardamagna O, Lia S, Benso A, Biolo GB, Maroni L, Lupi A, Bonanni L, Rinaldi E, Zenti MG, Masuda D, Mahfouz L, Jambart S, Ayoub C, Ghaleb Y, Kasim NAM, Nor NSM, Al-Khateeb A, Kadir SHSA, Chua YA, Razman AZ, Nazli SA, Ranai NM, Latif AZA, Torres MTM, Mehta R, Martagon AJ, Ramirez GAG, Antonio-Villa NE, Vargas-Vazquez A, Elias-Lopez D, Retana GG, Encinas BR, Macias JJC, Zazueta AR, Alvarado RM, Portano JDM, Lopez HA, Sauque-Reyna L, Gomez Herrera LG, Simental Mendia LE, Aguilar HG, Cooremans ER, Aparicio BP, Zubieta VM, Gonzalez PAC, Ferreira-Hermosillo A, Portilla NC, Dominguez GJ, Garcia AYR, Arriaga Cazares HE, Gonzalez Gonzalez JR, Mendez Valencia CV, Padilla Padilla FG, Prado RM, De los Rios Ibarra MO, Arjona Villica~na RD, Acevedo Rivera KJ, Carrera RA, Alvarez JA, Amezcua Martinez JC, Barrera Bustillo MDLR, Vargas GC, Chacon RC, Figueroa Andrade MH, Ortega AF, Alcala HG, Garcia de Leon LE, Guzman BG, Gardu~no Garcia JJ, Garnica Cuellar JC, Gomez Cruz JR, Garcia AH, Holguin Almada JR, Herrera UJ, Sobrevilla FL, Rodriguez EM, Sibaja CM, Medrano Rodriguez AB, Morales Oyervides JC, Perez Vazquez DI, Reyes Rodriguez EA, Osorio MLR, Saucedo JR, Tamayo MT, Valdez Talavera LA, Vera Arroyo LE, Zepeda Carrillo EA, Galema-Boers A, Weigman A, Bogsrud MP, Malik M, Shah S, Khan SA, Rana MA, Batool H, Starostecka E, Konopka A, Lewek J, Bielecka-Dąbrowa A, Gach A, Jóźwiak J, Pajkowski M, Romanowska-Kocejko M, Żarczyńska-Buchowiecka M, Hellmann M, Chmara M, Wasąg B, Parczewska A, Gilis-Malinowska N, Borowiec-Wolna J, Stróżyk A, Michalska-Grzonkowska A, Chlebus I, Kleinschmidt M, Wojtecka A, Zdrojewski T, Myśliwiec M, Hennig M, Medeiros AM, Alves AC, Almeida AF, Lopes A, Guerra A, Bilhoto C, Simões F, Silva F, Lobarinhas G, Gama G, Palma I, Salgado JM, Matos LD, Moura MD, Virtuoso MJ, Tavares M, Ferreira P, Pais P, Garcia P, Coelho R, Ribeiro R, Correia S, Sadykova D, Slastnikova E, Alammari D, Mawlawi HA, Alsahari A, Khudary AA, Alrowaily NL, Rajkovic N, Popovic L, Singh S, Rasulic I, Petakov A, Lalic NM, Peng FK, Vasanwala RF, Venkatesh SA, Raslova K, Fabryova L, Nociar J, Šaligova J, Potočňáková L, Kozárová M, Varga T, Kadurova M, Debreova M, Novodvorsky P, Gonova K, Klabnik A, Buganova I, Battelino T, Bizjan BJ, Debeljak M, Kovac J, Mlinaric M, Molk N, Sikonja J, Sustar U, Podkrajsek KT, Muñiz-Grijalvo O, Díaz-Díaz JL, de Andrés R, Fuentes-Jiménez F, Blom D, Miserez EB, Shipton JL, Ganokroj P, Futema M, Ramaswami U, Alieva RB, Fozilov KG, Khoshimov SU, Nizamov UI, Abdullaeva GJ, Kan LE, Abdullaev AA, Zakirova DV, Do DL, Nguyen MNT, Kim NT, Le TT, Le HA, Santos R, Ray KK. Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study. Lancet 2024; 403:55-66. [PMID: 38101429 DOI: 10.1016/s0140-6736(23)01842-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. METHODS For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. FINDINGS Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. INTERPRETATION Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life. FUNDING Pfizer, Amgen, Merck Sharp & Dohme, Sanofi-Aventis, Daiichi Sankyo, and Regeneron.
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Tsotra K, Garoufi A, Kossiva L, Gourgiotis D, Tsoukatou T, Katsantoni E, Stavropoulos P. The impact of vitamin D supplementation on serum cathelicidin levels and the clinical course of atopic dermatitis in children. Minerva Pediatr (Torino) 2023; 75:395-399. [PMID: 28643993 DOI: 10.23736/s2724-5276.17.04910-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Cathelicidin has been correlated with the pathophysiology of atopic dermatitis (AD). An indirect correlation of vitamin D with the course of the disease has already been reported as it directly affects the levels of cathelicidin. The purpose of the present article is to investigate the impact of vitamin D supplementation on the course of AD. METHODS We conducted a prospective observational study. The severity of AD was assessed with the clinical tool SCORAD (SCORing Atopic Dermatitis) which is developed by the European Task Force on AD. RESULTS Fifty children with AD were enrolled and stratified in two groups based on the severity of SCORAD. Children with severe AD (SCORAD Index >40) received higher doses of vitamin D in order to sufficiently reduce the disease (comparable SCORAD Index for children with mild atopic dermatitis). While the baseline SCORAD differed statistically significant level between the two groups of children with AD (P<0.001) this difference disappeared at 20 (P=0.649) days and remained statistically insignificant both at 45 days (P=0.610), and at the end of the administration of treatment (P=0.474). This effect was based on a significant downregulation of the severity of symptoms in the group of children that received 2400 IU of vitamin D. CONCLUSIONS The findings of our study suggest that vitamin D may be accurately used in current clinical practice for the management of AD. However, the recommended dose should be titrated taking in mind the severity of the disease.
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Affiliation(s)
- Kyriaki Tsotra
- Second Department of Pediatrics, Aglaia Kyriakou University Hospital, National and Kapodistrian University of Athens, Athens, Greece -
| | - Anastasia Garoufi
- Second Department of Pediatrics, Aglaia Kyriakou University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Lydia Kossiva
- Second Department of Pediatrics, Aglaia Kyriakou University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Gourgiotis
- Laboratory of Clinical Biochemistry-Molecular Diagnosis, Aglaia Kyriakou University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Theano Tsoukatou
- Second Department of Pediatrics, Aglaia Kyriakou University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Katsantoni
- Basic Research Center, Biomedical Research Foundation, Academy of Athens, Athens, Greece
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Rizos C, Liamis G, Garoufi A, Skoumas I, Rallidis L, Kolovou G, Tziomalos K, Skalidis E, Kotsis V, Lambadiari V, Anagnostis P, Dima I, Kiouri E, Kolovou V, Polychronopoulos G, Zacharis E, Antza C, Liberopoulos E. One year follow-up of patients with familial hypercholesterolemia: Preliminary data from the HELLAS-FH registry. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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Garoufi A, Koumparelou A, Askiti V, Lykoudis P, Mitsioni A, Drapanioti S, Servos G, Papadaki M, Gourgiotis D, Marmarinos A. Plasma Brain Natriuretic Peptide Levels in Children with Chronic Kidney Disease and Renal Transplant Recipients: A Single Center Study. Children 2022; 9:children9060916. [PMID: 35740855 PMCID: PMC9222167 DOI: 10.3390/children9060916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022]
Abstract
Pediatric chronic kidney disease (CKD) patients, as well as kidney transplant patients, are at an increased risk of developing cardiovascular disease. BNP measurement, as a biomarker of cardiovascular risk, has been recommended to this high-risk population. Plasma BNP levels were measured in 56 CKD children in either pre-dialysis stage, hemodialysis (HD) or renal transplant recipients (RTRs) and in 76 sex- and age-matched healthy controls. BNP levels were investigated in HD children, before and after the completion of their HD session. BNP levels in total CKD population, in pre-dialysis stage patients and on HD were significantly higher, compared to the respective controls. HD children had higher BNP levels compared to CKD patients in the pre-dialysis stage. Moreover, post-HD BNP concentration was slightly higher than pre-HD, with the difference being marginally statistically significant. BNP was positively correlated with eGFR, creatinine, cystatin-C and parathormone and negatively with albumin and 25-hydroxyvitamin D. A positive correlation between BNP concentration and the ratio of E/A in pulse-wave Doppler echocardiography was also observed. In conclusion, CKD pediatric patients, mainly those undergoing HD, have high plasma BNP levels which do not decrease after the HD session. This is indicative of a greater risk for future cardiovascular disease.
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Affiliation(s)
- Anastasia Garoufi
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, National and Kapodistrian University of Athens (NKUA), “P. & A. Kyriakou” Children’s Hospital, Thivon & Levadias Str., 11527 Athens, Greece; (A.G.); (S.D.); (M.P.)
| | - Aikaterini Koumparelou
- 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, 11527 Athens, Greece;
| | - Varvara Askiti
- Department of Nephrology, “P. & A. Kyriakou” Children’s Hospital, 11527 Athens, Greece; (V.A.); (A.M.)
| | - Panagis Lykoudis
- Honorary Lectures Division of Surgery of International Science, University of College London (UCL), Gower St, London WC1E 6BT, UK;
| | - Andromachi Mitsioni
- Department of Nephrology, “P. & A. Kyriakou” Children’s Hospital, 11527 Athens, Greece; (V.A.); (A.M.)
| | - Styliani Drapanioti
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, National and Kapodistrian University of Athens (NKUA), “P. & A. Kyriakou” Children’s Hospital, Thivon & Levadias Str., 11527 Athens, Greece; (A.G.); (S.D.); (M.P.)
| | - Georgios Servos
- Pediatric Cardiology Unit, “P. & A. Kyriakou” Children’s Hospital, 11527 Athens, Greece;
| | - Maria Papadaki
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, National and Kapodistrian University of Athens (NKUA), “P. & A. Kyriakou” Children’s Hospital, Thivon & Levadias Str., 11527 Athens, Greece; (A.G.); (S.D.); (M.P.)
| | - Dimitrios Gourgiotis
- Laboratory of Clinical Biochemistry—Molecular Diagnostic, 2nd Department of Pediatrics, Medical School, NKUA, “P. & A. Kyriakou” Children’s Hospital, 24 Mesogeion Avn, 11527 Athens, Greece;
| | - Antonios Marmarinos
- Laboratory of Clinical Biochemistry—Molecular Diagnostic, 2nd Department of Pediatrics, Medical School, NKUA, “P. & A. Kyriakou” Children’s Hospital, 24 Mesogeion Avn, 11527 Athens, Greece;
- Correspondence:
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Anagnostis P, Rizos CV, Skoumas I, Rallidis L, Tziomalos K, Skalidis E, Kotsis V, Doumas M, Kolovou G, Sfikas G, Garoufi A, Lambadiari V, Dima I, Kiouri E, Agapakis D, Zacharis E, Antza C, Kolovou V, Koumaras C, Bantouvakis G, Liamis G, Liberopoulos EN. Association between lipoprotein(a) concentrations and atherosclerotic cardiovascular disease risk in patients with familial hypercholesterolemia: an analysis from the HELLAS-FH. Endocrine 2022; 76:324-330. [PMID: 35262845 DOI: 10.1007/s12020-022-03013-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/06/2022] [Indexed: 11/03/2022]
Abstract
AIMS Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) in the general population. However, such a role in patients with familial hypercholesterolemia (FH) is less documented. The purpose of this study was to evaluate the association between Lp(a) concentrations and ASCVD prevalence in adult patients with FH. METHODS This was a cross-sectional study from the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH). Patients were categorized into 3 tertiles according to Lp(a) levels. RESULTS A total of 541 adult patients (249 males) with possible/probable/definite FH heterozygous FH (HeFH) were included (mean age 48.5 ± 15.0 years at registration, 40.8 ± 15.9 years at diagnosis). Median (interquartile range) Lp(a) concentrations in the 1st, 2nd and 3rd Lp(a) tertile were 6.4 (3.0-9.7), 22.4 (16.0-29.1) and 77.0 (55.0-102.0) mg/dL, respectively. There was no difference in lipid profile across Lp(a) tertiles. The overall prevalence of ASCVD was 9.4% in the first, 16.1% in the second and 20.6% in the third tertile (p = 0.012 among tertiles). This was also the case for premature ASCVD, with prevalence rates of 8.5, 13.4 and 19.8%, respectively (p = 0.010 among tertiles). A trend for increasing prevalence of coronary artery disease (8.3, 12.2 and 16.1%, respectively; p = 0.076 among tertiles) was also observed. No difference in the prevalence of stroke and peripheral artery disease was found across tertiles. CONCLUSIONS Elevated Lp(a) concentrations are significantly associated with increased prevalence of ASCVD in patients with possible/probable/definite HeFH.
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Affiliation(s)
- Panagiotis Anagnostis
- Department of Endocrinology, Police Medical Centre of Thessaloniki, Thessaloniki, Greece
| | - Christos V Rizos
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Ioannis Skoumas
- Cardiology Clinic, Hippokration General Hospital, Athens, Greece
| | - Loukianos Rallidis
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Konstantinos Tziomalos
- 1st Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Emmanuel Skalidis
- Cardiology Clinic, University General Hospital of Heraklion, Heraklion, Greece
| | - Vasileios Kotsis
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital Thessaloniki, Thessaloniki, Greece
| | - Michalis Doumas
- 2nd Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Genovefa Kolovou
- Cardiometabolic Center, Lipid Clinic, LA apheresis Unit, Metropolitan Hospital, Athens, Greece
| | - George Sfikas
- Department of Internal Medicine, 424 General Military Training Hospital, Thessaloniki, Greece
| | - Anastasia Garoufi
- Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Β' Pediatrics Clinic, General Children's Hospital "Pan. & Aglaia Kyriakou", Athens, Greece
| | - Vaia Lambadiari
- 2nd Propedeutic Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Ioanna Dima
- Cardiology Clinic, Hippokration General Hospital, Athens, Greece
| | - Estela Kiouri
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Dimitrios Agapakis
- 1st Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
- Department of Internal Medicine, General Hospital of Goumenissa, Goumenissa, Greece
| | - Evangelos Zacharis
- Cardiology Clinic, University General Hospital of Heraklion, Heraklion, Greece
| | - Christina Antza
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital Thessaloniki, Thessaloniki, Greece
| | - Vana Kolovou
- Cardiometabolic Center, Lipid Clinic, LA apheresis Unit, Metropolitan Hospital, Athens, Greece
| | - Charalambos Koumaras
- Department of Internal Medicine, 424 General Military Training Hospital, Thessaloniki, Greece
| | - George Bantouvakis
- Cardiology Clinic, University General Hospital of Heraklion, Heraklion, Greece
| | - George Liamis
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Evangelos N Liberopoulos
- Department of Endocrinology, Police Medical Centre of Thessaloniki, Thessaloniki, Greece.
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
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Skella P, Chelmi ME, Panagouli E, Garoufi A, Psaltopoulou T, Mastorakos G, Sergentanis TN, Tsitsika A. Orthorexia and Eating Disorders in Adolescents and Young Adults: A Systematic Review. Children 2022; 9:children9040514. [PMID: 35455559 PMCID: PMC9030415 DOI: 10.3390/children9040514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/17/2022] [Accepted: 03/22/2022] [Indexed: 12/17/2022]
Abstract
Background: In recent years a new term in the field of eating behaviors has emerged, namely “orthorexia”. This behavior is associated with significant dietary restrictions and omission of food groups. The aim of the present study is to estimate the possible correlations between orthorexia and eating disorders in young adults and adolescents. Methods: A systematic review of related articles in PubMed, Google Scholar, and PsycInfo was conducted up to 30 June 2021. Results: A total of 37 studies (16,402 subjects) were considered eligible for this systematic review. Significant correlations were observed in most of the studies between orthorexia and eating disorders. However, the majority of studies adopted a cross-sectional design. Conclusions: An association between and eating disorders emerged. Prospective studies seem necessary to investigate associations and succession of orthorexia and eating disorders over time.
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Affiliation(s)
- Panagiota Skella
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
| | - Maria Eleni Chelmi
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Clinical Psychopathology, University of Macedonia, 546 36 Thessaloniki, Greece
| | - Eleni Panagouli
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
| | - Anastasia Garoufi
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
| | - Theodora Psaltopoulou
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - George Mastorakos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece;
| | - Theodoros N. Sergentanis
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Department of Public Health Policy, University of West Attica, 122 43 Athens, Greece
| | - Artemis Tsitsika
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Correspondence: ; Tel.: +30-216-0033788
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Garoufi A, Pagoni A, Papadaki M, Marmarinos A, Karapostolakis G, Michala L, Soldatou A. Cardiovascular Risk Factors and Subclinical Atherosclerosis in Greek Adolescents with Polycystic Ovary Syndrome: Its Relationship with Body Mass Index. Children 2021; 9:children9010004. [PMID: 35053629 PMCID: PMC8773958 DOI: 10.3390/children9010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting 6–18% of adolescents and is strongly associated with obesity and cardiovascular risk factors, enhancing the risk of atherosclerosis. Thirty-two adolescents with newly diagnosed PCOS were evaluated for lipid profile disorders, insulin resistance, inflammation, non-alcoholic fatty liver disease (NAFLD), and subclinical atherosclerosis through measurements of carotid intima–media thickness (cIMT). The relationships of the above markers with increased body mass index and abdominal obesity were investigated. Twenty-three adolescents (72%) were overweight (OW) or obese (OB). The OW/OB group had significantly higher insulin, HOMA-IR, high-sensitive C-reactive protein (hsCRP), visceral adiposity index (VAI), and lipid accumulation product (LAP) levels; and lower glucose-per-insulin ratios and HDL-C levels compared to the healthy weight group. The cIMT and small dense low-density lipoprotein cholesterol (sdLDL-C) levels did not differ between the two groups. Similarly, cIMT and sdLDL-C levels did not differ between PCOS-adolescents and healthy controls. CIMT was positively correlated with systolic blood pressure and waist circumference per height ratio. In conclusion, OW/OB PCOS-adolescents have a cluster of adverse factors predisposing them to atherosclerotic cardiovascular disease. Therefore, early cardiovascular risk assessment, as well as timely and targeted interventions, are necessary for prevention.
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Affiliation(s)
- Anastasia Garoufi
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens (NKUA), Thivon & Levadias Str., Goudi, 11527 Athens, Greece; (A.G.); (A.P.); (M.P.)
| | - Athanasia Pagoni
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens (NKUA), Thivon & Levadias Str., Goudi, 11527 Athens, Greece; (A.G.); (A.P.); (M.P.)
| | - Maria Papadaki
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens (NKUA), Thivon & Levadias Str., Goudi, 11527 Athens, Greece; (A.G.); (A.P.); (M.P.)
| | - Antonios Marmarinos
- Laboratory of Clinical Biochemistry—Molecular Diagnostic, 2nd Department of Pediatrics, Medical School, NKUA, “P. & A. Kyriakou” Children’s Hospital, 11527 Athens, Greece;
| | - Georgios Karapostolakis
- Radiology Department, 401 Military General Hospital of Athens (MGHA), 138 Mesogeion Av., 11525 Athens, Greece;
| | - Lina Michala
- First Department of Obstetrics and Gynaecology, Medical School, Alexandra General Hospital, National and Kapodistrian University of Athens (NKUA), 80 Vassilissis Sofias Av., 11528 Athens, Greece;
| | - Alexandra Soldatou
- Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens (NKUA), Thivon & Levadias Str., Goudi, 11527 Athens, Greece; (A.G.); (A.P.); (M.P.)
- Correspondence:
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Rizos CV, Skoumas I, Rallidis L, Skalidis E, Tziomalos K, Garoufi A, Anagnostis P, Sfikas G, Kotsis V, Doumas M, Kolovou G, Lambadiari V, Dima I, Kiouri E, Zacharis E, Agapakis D, Attilakos A, Antza C, Vlachopoulos C, Liberopoulos EN. LDL cholesterol target achievement in heterozygous familial hypercholesterolemia patients according to 2019 ESC/EAS lipid guidelines: Implications for newer lipid-lowering treatments. Int J Cardiol 2021; 345:119-124. [PMID: 34687802 DOI: 10.1016/j.ijcard.2021.10.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/09/2021] [Accepted: 10/15/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND The 2019 European guidelines (ESC/EAS) for the treatment of dyslipidaemias recommend more aggressive targets for low-density lipoprotein cholesterol (LDL-C) in patients with familial hypercholesterolemia (FH). Current lipid-lowering treatment is often inadequate to achieve these targets. METHODS Data from the HELLAS-FH registry were analysed to assess achievement of LDL-C targets in adults with FH based on the 2019 ESC/EAS guidelines. In patients who had not achieved LDL-C target, the maximally reduced LDL-C value was calculated after theoretical switch to rosuvastatin/ezetimibe 40/10 mg/day. The percentage of patients who remained candidates for proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) was then calculated. RESULTS Patients (n = 1694, mean age 50.8 ± 14.7 years) had LDL-C levels 242 ± 71 mg/dL (6.3 ± 1.8 mmol/L) at diagnosis. Most treated patients were receiving statins (97.5%) and about half were on additional ezetimibe (47.5%). Based on the 2019 ESC/EAS guidelines the percentage of patients achieving LDL-C goals was only 2.7%. Following theoretical up titration to rosuvastatin/ezetimibe 40/10 mg, LDL-C target achievement rate would increase to 5.9%. In this scenario, most patients (55.9%) would be eligible for PCSK9i treatment. Following theoretical administration of a PCSK9i, LDL-C target achievement rate would rise to 57.6%. However, 42.4% of patients would still be eligible for further LDL-C lowering treatment. CONCLUSIONS Most FH patients do not reach new LDL-C targets even if on maximum intensity statin/ezetimibe treatment. In this case, more than half of FH patients are candidates for PCSK9i therapy and a considerable proportion may still require additional LDL-C lowering.
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Affiliation(s)
- Christos V Rizos
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Ioannis Skoumas
- Cardiology Clinic, Hippokration General Hospital, Athens, Greece
| | - Loukianos Rallidis
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Emmanouil Skalidis
- Cardiology Clinic, University General Hospital of Heraklion, Heraklion, Greece
| | - Konstantinos Tziomalos
- 1st Propaedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Anastasia Garoufi
- Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Β' Pediatrics Clinic, General Children's Hospital "Pan. & Aglaia Kyriakou", Athens, Greece
| | | | - George Sfikas
- Department of Internal Medicine, 424 General Military Training Hospital, Thessaloniki, Greece
| | - Vasileios Kotsis
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital Thessaloniki, Thessaloniki, Greece
| | - Michalis Doumas
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Genovefa Kolovou
- Cardiometabolic Center, Lipid Clinic, LA apheresis Unit, Metropolitan Hospital, Athens, Greece
| | - Vaia Lambadiari
- 2nd Propaedeutic Internal Medicine Department and Diabetes Research Unit, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Ioanna Dima
- Cardiology Clinic, Hippokration General Hospital, Athens, Greece
| | - Estela Kiouri
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Evangelos Zacharis
- Cardiology Clinic, University General Hospital of Heraklion, Heraklion, Greece
| | - Dimitrios Agapakis
- 1st Propaedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece; Department of Internal Medicine, Goumenissa, Greece
| | - Achilleas Attilakos
- Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, C' Pediatrics Clinic, Attikon University General Hospital, Athens, Greece
| | - Christina Antza
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital Thessaloniki, Thessaloniki, Greece
| | - Charalambos Vlachopoulos
- 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
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Papailiou S, Markade A, Eleftheriou I, Tsolia MN, Garoufi A, Maritsi DN. A National Survey Across Primary Care Pediatricians Regarding Immunization Views and Practices in Children With Rheumatic Diseases. J Clin Rheumatol 2021; 27:e588-e590. [PMID: 31972735 DOI: 10.1097/rhu.0000000000001251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
METHODS Cross-sectional survey conducted with an anonymous questionnaire of 34 items distributed to pediatricians via an online platform. Four hundred questionnaires were sent, and 256 were returned and analyzed using STATA 13. Data collection included demographics, questions on knowledge, perceptions, and opinions, as well as advice given to families. RESULTS The majority of doctors felt that vaccination in children with RDs is essential. Responders were using a variety of guidelines to reach a clinical decision. Fifty percent were hesitant to adhere to the national vaccination scheme without expert input. Reasons were as follows: not convinced from current literature that the vaccine is safe (32%), afraid to cause disease flare (43%), and unable to deal with parental concerns/refusal (54%). Twelve percent of responders felt that the RD may have been triggered by a vaccine. The majority (82%) of doctors were pro annual influenza vaccination. Seventy percent of doctors were keener to administer booster doses rather than primary ones. CONCLUSIONS Variation in opinion and clinical practice exists. Overall, although general pediatricians are informed regarding efficacy and adverse effects of immunizations in patients with RDs, there are steps to be made from principle to practice. Vaccinating these children is of vital importance, and primary care pediatricians should be updated regarding existing guidelines referring to this field.
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Affiliation(s)
- Stayroula Papailiou
- From the Unit of Rheumatology, Immunology, and Infectious Diseases, Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Vallejo-Vaz AJ, Stevens CA, Lyons AR, Dharmayat KI, Freiberger T, Hovingh GK, Mata P, Raal FJ, Santos RD, Soran H, Watts GF, Abifadel M, Aguilar-Salinas CA, Alhabib KF, Alkhnifsawi M, Almahmeed W, Alnouri F, Alonso R, Al-Rasadi K, Al-Sarraf A, Al-Sayed N, Araujo F, Ashavaid TF, Banach M, Béliard S, Benn M, Binder CJ, Bogsrud MP, Bourbon M, Chlebus K, Corral P, Davletov K, Descamps OS, Durst R, Ezhov M, Gaita D, Genest J, Groselj U, Harada-Shiba M, Holven KB, Kayikcioglu M, Khovidhunkit W, Lalic K, Latkovskis G, Laufs U, Liberopoulos E, Lima-Martinez MM, Lin J, Maher V, Marais AD, März W, Mirrakhimov E, Miserez AR, Mitchenko O, Nawawi H, Nordestgaard BG, Panayiotou AG, Paragh G, Petrulioniene Z, Pojskic B, Postadzhiyan A, Raslova K, Reda A, Reiner Ž, Sadiq F, Sadoh WE, Schunkert H, Shek AB, Stoll M, Stroes E, Su TC, Subramaniam T, Susekov AV, Tilney M, Tomlinson B, Truong TH, Tselepis AD, Tybjærg-Hansen A, Vázquez Cárdenas A, Viigimaa M, Wang L, Yamashita S, Kastelein JJ, Bruckert E, Vohnout B, Schreier L, Pang J, Ebenbichler C, Dieplinger H, Innerhofer R, Winhofer-Stöckl Y, Greber-Platzer S, Krychtiuk K, Speidl W, Toplak H, Widhalm K, Stulnig T, Huber K, Höllerl F, Rega-Kaun G, Kleemann L, Mäser M, Scholl-Bürgi S, Säly C, Mayer FJ, Sablon G, Tarantino E, Nzeyimana C, Pojskic L, Sisic I, Nalbantic AD, Jannes CE, Pereira AC, Krieger JE, Petrov I, Goudev A, Nikolov F, Tisheva S, Yotov Y, Tzvetkov I, Baass A, Bergeron J, Bernard S, Brisson D, Brunham LR, Cermakova L, Couture P, Francis GA, Gaudet D, Hegele RA, Khoury E, Mancini GJ, McCrindle BW, Paquette M, Ruel I, Cuevas A, Asenjo S, Wang X, Meng K, Song X, Yong Q, Jiang T, Liu Z, Duan Y, Hong J, Ye P, Chen Y, Qi J, Liu Z, Li Y, Zhang C, Peng J, Yang Y, Yu W, Wang Q, Yuan H, Cheng S, Jiang L, Chong M, Jiao J, Wu Y, Wen W, Xu L, Zhang R, Qu Y, He J, Fan X, Wang Z, Chow E, Pećin I, Perica D, Symeonides P, Vrablik M, Ceska R, Soska V, Tichy L, Adamkova V, Franekova J, Cifkova R, Kraml P, Vonaskova K, Cepova J, Dusejovska M, Pavlickova L, Blaha V, Rosolova H, Nussbaumerova B, Cibulka R, Vaverkova H, Cibickova L, Krejsova Z, Rehouskova K, Malina P, Budikova M, Palanova V, Solcova L, Lubasova A, Podzimkova H, Bujdak J, Vesely J, Jordanova M, Salek T, Urbanek R, Zemek S, Lacko J, Halamkova H, Machacova S, Mala S, Cubova E, Valoskova K, Burda L, Bendary A, Daoud I, Emil S, Elbahry A, Rafla S, Sanad O, Kazamel G, Ashraf M, Sobhy M, El-Hadidy A, Shafy MA, Kamal S, Bendary M, Talviste G, Angoulvant D, Boccara F, Cariou B, Carreau V, Carrie A, Charrieres S, Cottin Y, Di-Fillipo M, Ducluzeau PH, Dulong S, Durlach V, Farnier M, Ferrari E, Ferrieres D, Ferrieres J, Gallo A, hankard R, Inamo J, Lemale J, Moulin P, Paillard F, Peretti N, Perrin A, Pradignac A, Rabes JP, Rigalleau V, Sultan A, Schiele F, Tounian P, Valero R, Verges B, Yelnik C, Ziegler O, Haack IA, Schmidt N, Dressel A, Klein I, Christmann J, Sonntag A, Stumpp C, Boger D, Biedermann D, Usme MM, Beil FU, Klose G, König C, Gouni-Berthold I, Otte B, Böll G, Kirschbaum A, Merke J, Scholl J, Segiet T, Gebauer M, Predica F, Mayer M, Leistikow F, Füllgraf-Horst S, Müller C, Schüler M, Wiener J, Hein K, Baumgartner P, Kopf S, Busch R, Schömig M, Matthias S, Allendorf-Ostwald N, Fink B, Böhm D, Jäkel A, Koschker AC, Schweizer R, Vogt A, Parhofer K, König W, Reinhard W, Bäßler A, Stadelmann A, Schrader V, Katzmann J, Tarr A, Steinhagen-Thiessen E, Kassner U, Paulsen G, Homberger J, Zemmrich C, Seeger W, Biolik K, Deiss D, Richter C, Pantchechnikova E, Dorn E, Schatz U, Julius U, Spens A, Wiesner T, Scholl M, Rizos CV, Sakkas N, Elisaf M, Skoumas I, Tziomalos K, Rallidis L, Kotsis V, Doumas M, Athyros V, Skalidis E, Kolovou G, Garoufi A, Bilianou E, Koutagiar I, Agapakis D, Kiouri E, Antza C, Katsiki N, Zacharis E, Attilakos A, Sfikas G, Koumaras C, Anagnostis P, Anastasiou G, Liamis G, Koutsogianni AD, Karányi Z, Harangi M, Bajnok L, Audikovszky M, Márk L, Benczúr B, Reiber I, Nagy G, Nagy A, Reddy LL, Shah SA, Ponde CK, Dalal JJ, Sawhney JP, Verma IC, Altaey M, Al-Jumaily K, Rasul D, Abdalsahib AF, Jabbar AA, Al-ageedi M, Agar R, Cohen H, Ellis A, Gavishv D, Harats D, Henkin Y, Knobler H, Leavit L, Leitersdorf E, Rubinstein A, Schurr D, Shpitzen S, Szalat A, Casula M, Zampoleri V, Gazzotti M, Olmastroni E, Sarzani R, Ferri C, Repetti E, Sabbà C, Bossi AC, Borghi C, Muntoni S, Cipollone F, Purrello F, Pujia A, Passaro A, Marcucci R, Pecchioli V, Pisciotta L, Mandraffino G, Pellegatta F, Mombelli G, Branchi A, Fiorenza AM, Pederiva C, Werba JP, Parati G, Carubbi F, Iughetti L, Iannuzzi A, Iannuzzo G, Calabrò P, Averna M, Biasucci G, Zambon S, Roscini AR, Trenti C, Arca M, Federici M, Del Ben M, Bartuli A, Giaccari A, Pipolo A, Citroni N, Guardamagna O, Bonomo K, Benso A, Biolo G, Maroni L, Lupi A, Bonanni L, Zenti MG, Matsuki K, Hori M, Ogura M, Masuda D, Kobayashi T, Nagahama K, Al-Jarallah M, Radovic M, Lunegova O, Bektasheva E, Khodzhiboboev E, Erglis A, Gilis D, Nesterovics G, Saripo V, Meiere R, Upena-RozeMicena A, Terauda E, Jambart S, Khoury PE, Elbitar S, Ayoub C, Ghaleb Y, Aliosaitiene U, Kutkiene S, Kasim NA, Nor NS, Ramli AS, Razak SA, Al-Khateeb A, Kadir SH, Muid SA, Rahman TA, Kasim SS, Radzi AB, Ibrahim KS, Razali S, Ismail Z, Ghani RA, Hafidz MI, Chua AL, Rosli MM, Annamalai M, Teh LK, Razali R, Chua YA, Rosman A, Sanusi AR, Murad NA, Jamal ARA, Nazli SA, Razman AZ, Rosman N, Rahmat R, Hamzan NS, Azzopardi C, Mehta R, Martagon AJ, Ramirez GA, Villa NE, Vazquez AV, Elias-Lopez D, Retana GG, Rodriguez B, Macías JJ, Zazueta AR, Alvarado RM, Portano JD, Lopez HA, Sauque-Reyna L, Herrera LG, Mendia LE, Aguilar HG, Cooremans ER, Aparicio BP, Zubieta VM, Gonzalez PA, Ferreira-Hermosillo A, Portilla NC, Dominguez GJ, Garcia AY, Cazares HE, Gonzalez JR, Valencia CV, Padilla FG, Prado RM, De los Rios Ibarra MO, Villicaña RD, Rivera KJ, Carrera RA, Alvarez JA, Martinez JC, de los Reyes Barrera Bustillo M, Vargas GC, Chacon RC, Andrade MH, Ortega AF, Alcala HG, de Leon LE, Guzman BG, Garcia JJ, Cuellar JC, Cruz JR, Garcia AH, Almada JR, Herrera UJ, Sobrevilla FL, Rodriguez EM, Sibaja CM, Rodriguez AB, Oyervides JC, Vazquez DI, Rodriguez EA, Osorio ML, Saucedo JR, Tamayo MT, Talavera LA, Arroyo LE, Carrillo EA, Isara A, Obaseki DE, Al-Waili K, Al-Zadjali F, Al-Zakwani I, Al-Kindi M, Al-Mukhaini S, Al-Barwani H, Rana A, Shah LS, Starostecka E, Konopka A, Lewek J, Bartłomiejczyk M, Gąsior M, Dyrbuś K, Jóźwiak J, Gruchała M, Pajkowski M, Romanowska-Kocejko M, Żarczyńska-Buchowiecka M, Chmara M, Wasąg B, Parczewska A, Gilis-Malinowska N, Borowiec-Wolna J, Stróżyk A, Woś M, Michalska-Grzonkowska A, Medeiros AM, Alves AC, Silva F, Lobarinhas G, Palma I, de Moura JP, Rico MT, Rato Q, Pais P, Correia S, Moldovan O, Virtuoso MJ, Salgado JM, Colaço I, Dumitrescu A, Lengher C, Mosteoru S, Meshkov A, Ershova A, Rozkova T, Korneva V, Yu KT, Zafiraki V, Voevoda M, Gurevich V, Duplyakov D, Ragino Y, Safarova M, Shaposhnik I, Alkaf F, Khudari A, Rwaili N, Al-Allaf F, Alghamdi M, Batais MA, Almigbal TH, Kinsara A, AlQudaimi AH, Awan Z, Elamin OA, Altaradi H, Rajkovic N, Popovic L, Singh S, Stosic L, Rasulic I, Lalic NM, Lam C, Le TJ, Siang EL, Dissanayake S, I-Shing JT, Shyong TE, Jin TC, Balinth K, Buganova I, Fabryova L, Kadurova M, Klabnik A, Kozárová M, Sirotiakova J, Battelino T, Kovac J, Mlinaric M, Sustar U, Podkrajsek KT, Fras Z, Jug B, Cevc M, Pilcher GJ, Blom D, Wolmarans K, Brice B, Muñiz-Grijalvo O, Díaz-Díaz JL, de Isla LP, Fuentes F, Badimon L, Martin F, Lux A, Chang NT, Ganokroj P, Akbulut M, Alici G, Bayram F, Can LH, Celik A, Ceyhan C, Coskun FY, Demir M, Demircan S, Dogan V, Durakoglugil E, Dural IE, Gedikli O, Hacioglu A, Ildizli M, Kilic S, Kirilmaz B, Kutlu M, Oguz A, Ozdogan O, Onrat E, Ozer S, Sabuncu T, Sahin T, Sivri F, Sonmez A, Temizhan A, Topcu S, Tuncez A, Vural M, Yenercag M, Yesilbursa D, Yigit Z, Yildirim AB, Yildirir A, Yilmaz MB, Atallah B, Traina M, Sabbour H, Hay DA, Luqman N, Elfatih A, Abdulrasheed A, Kwok S, Oca ND, Reyes X, Alieva RB, Kurbanov RD, Hoshimov SU, Nizamov UI, Ziyaeva AV, Abdullaeva GJ, Do DL, Nguyen MN, Kim NT, Le TT, Le HA, Tokgozoglu L, Catapano AL, Ray KK. Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC). Lancet 2021; 398:1713-1725. [PMID: 34506743 DOI: 10.1016/s0140-6736(21)01122-3] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND The European Atherosclerosis Society Familial Hypercholesterolaemia Studies Collaboration (FHSC) global registry provides a platform for the global surveillance of familial hypercholesterolaemia through harmonisation and pooling of multinational data. In this study, we aimed to characterise the adult population with heterozygous familial hypercholesterolaemia and described how it is detected and managed globally. METHODS Using FHSC global registry data, we did a cross-sectional assessment of adults (aged 18 years or older) with a clinical or genetic diagnosis of probable or definite heterozygous familial hypercholesterolaemia at the time they were entered into the registries. Data were assessed overall and by WHO regions, sex, and index versus non-index cases. FINDINGS Of the 61 612 individuals in the registry, 42 167 adults (21 999 [53·6%] women) from 56 countries were included in the study. Of these, 31 798 (75·4%) were diagnosed with the Dutch Lipid Clinic Network criteria, and 35 490 (84·2%) were from the WHO region of Europe. Median age of participants at entry in the registry was 46·2 years (IQR 34·3-58·0); median age at diagnosis of familial hypercholesterolaemia was 44·4 years (32·5-56·5), with 40·2% of participants younger than 40 years when diagnosed. Prevalence of cardiovascular risk factors increased progressively with age and varied by WHO region. Prevalence of coronary disease was 17·4% (2·1% for stroke and 5·2% for peripheral artery disease), increasing with concentrations of untreated LDL cholesterol, and was about two times lower in women than in men. Among patients receiving lipid-lowering medications, 16 803 (81·1%) were receiving statins and 3691 (21·2%) were on combination therapy, with greater use of more potent lipid-lowering medication in men than in women. Median LDL cholesterol was 5·43 mmol/L (IQR 4·32-6·72) among patients not taking lipid-lowering medications and 4·23 mmol/L (3·20-5·66) among those taking them. Among patients taking lipid-lowering medications, 2·7% had LDL cholesterol lower than 1·8 mmol/L; the use of combination therapy, particularly with three drugs and with proprotein convertase subtilisin-kexin type 9 inhibitors, was associated with a higher proportion and greater odds of having LDL cholesterol lower than 1·8 mmol/L. Compared with index cases, patients who were non-index cases were younger, with lower LDL cholesterol and lower prevalence of cardiovascular risk factors and cardiovascular diseases (all p<0·001). INTERPRETATION Familial hypercholesterolaemia is diagnosed late. Guideline-recommended LDL cholesterol concentrations are infrequently achieved with single-drug therapy. Cardiovascular risk factors and presence of coronary disease were lower among non-index cases, who were diagnosed earlier. Earlier detection and greater use of combination therapies are required to reduce the global burden of familial hypercholesterolaemia. FUNDING Pfizer, Amgen, Merck Sharp & Dohme, Sanofi-Aventis, Daiichi Sankyo, and Regeneron.
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Rizos C, Skoumas I, Skalides E, Rallidis L, Tziomalos K, Sfikas G, Garoufi A, Anagnostis P, Kolovou G, Kotsis V, Doumas M, Bilianou E, Koutagiar I, Zacharis E, Kiouri E, Bantouvakis G, Agapakis D, Attilakos A, Antza C, Liberopoulos E. Implication of ESC/EAS 2019 dyslipidemia guidelines for PCSK9 inhibition in patients with familial hypercholesterolemia: An analysis from the Hellas-FH registry. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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Rizos C, Skoumas I, Skalides E, Rallidis L, Tziomalos K, Sfikas G, Garoufi A, Anagnostis P, Kolovou G, Kotsis V, Doumas M, Bilianou E, Koutagiar I, Zacharis E, Kiouri E, Bantouvakis G, Agapakis D, Attilakos A, Antza C, Koutsogianni AD, Liberopoulos E. Lipid profile and body mass index in patients with familial hypercholesterolemia: An analysis from the HELLAS-FH registry. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Vartzelis G, Attilakos A, Tsentidis C, Kalimeraki I, Maritsi D, Marmarinos A, Garoufi A. Plasma brain natriuretic peptide levels in children with idiopathic epilepsy treated with longterm sodium valproate and oxcarbazepine monotherapy. J BIOL REG HOMEOS AG 2021; 35:3. [PMID: 34278773 DOI: 10.23812/21-126-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- G Vartzelis
- Second Department of Pediatrics, National and Kapodistrian University of Athens, P.A. Kyriakou Children's Hospital, Athens, Greece
| | - A Attilakos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - C Tsentidis
- Second Department of Pediatrics, National and Kapodistrian University of Athens, P.A. Kyriakou Children's Hospital, Athens, Greece
| | - I Kalimeraki
- Second Department of Pediatrics, National and Kapodistrian University of Athens, P.A. Kyriakou Children's Hospital, Athens, Greece
| | - D Maritsi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, P.A. Kyriakou Children's Hospital, Athens, Greece
| | - A Marmarinos
- Second Department of Pediatrics, National and Kapodistrian University of Athens, P.A. Kyriakou Children's Hospital, Athens, Greece
| | - A Garoufi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, P.A. Kyriakou Children's Hospital, Athens, Greece
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Kolovou G, Kolovou V, Bilianou H, Goumas G, Foussas S, Grapsa E, Garoufi A, Karavolias G, Mavrogieni S, Melidonis A, Milionis H, Rallidis L, Richter D, Skoumas I, Tousoulis D, Vlachopoulos C, Liberopoulos E. Lipoprotein apheresis: a Hellenic consensus on its clinical use. Hellenic J Cardiol 2020; 62:460-462. [PMID: 33388425 DOI: 10.1016/j.hjc.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/10/2020] [Accepted: 12/24/2020] [Indexed: 10/22/2022] Open
Affiliation(s)
- Genovefa Kolovou
- Metropolitan Hospital, Cardiometabolic Center, Lipoprotein Apheresis and Lipid Disorders Clinic, Athens, Greece.
| | - Vana Kolovou
- Metropolitan Hospital, Cardiometabolic Center, Lipoprotein Apheresis and Lipid Disorders Clinic, Athens, Greece
| | | | | | - Stefanos Foussas
- Cardiology Department, Metropolitan General Hospital, Athens, Greece
| | - Eirini Grapsa
- Aretaieio University Hospital National and Kapodistrian University of Athens, Greece
| | - Anastasia Garoufi
- 2nd Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | | | - Sophie Mavrogieni
- Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
| | | | - Haralampos Milionis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Greece
| | - Loukianos Rallidis
- 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, University General Hospital Attikon, Athens, Greece
| | | | - Ioannis Skoumas
- Cardiology Department, Hippokration Hospital, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Charalambos Vlachopoulos
- 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Evangelos Liberopoulos
- Department of Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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20
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Rizos C, Elisaf M, Skoumas I, Rallidis L, Tziomalos K, Skalides E, Kotsis V, Garoufi A, Athyros V, Kolovou G, Sfikas G, Bilianou E, Koutagiar I, Kiouri E, Agapakis D, Zacharis E, Antza C, Attilakos A, Katsiki N, Liberopoulos E. Coexistence of cardiovascular risk factors in patients with familial hypercholesterolemia: Data from the HELLAS-FH registry. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Rizos C, Liamis G, Skoumas I, Rallidis L, Tziomalos K, Skalides E, Kotsis V, Garoufi A, Athyros V, Kolovou G, Sfikas G, Bilianou E, Koutagiar I, Kiouri E, Agapakis D, Zacharis E, Antza C, Attilakos A, Katsiki N, Anagnostis P, Koumaras C, Liberopoulos E. Clinical characteristics of patients with familial hypercholesterolemia: Data from the HELLAS-FH registry. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Koniari E, Skouma A, Dragoti A, Garoufi A, Maroulis V, Papadakis M, Chrousos G. Spectrum of LDLR gene mutations, causing familial hypercholesterolemia (FH) in Greece: Un update. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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23
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Rizos C, Liamis G, Skoumas I, Rallidis L, Tziomalos K, Skalides E, Kotsis V, Garoufi A, Athyros V, Kolovou G, Sfikas G, Bilianou E, Koutagiar I, Kiouri E, Agapakis D, Zacharis E, Antza C, Attilakos A, Katsiki N, Koumaras C, Liberopoulos E. Cholesterol levels of high-density lipoprotein (HDL-C), APOB/APOA1 ratio and cardiovascular risk in patients with familial hypercholesterolemia (FH): Data from the HELLAS-FH registry. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Rizos C, Skoumas I, Rallidis L, Tziomalos K, Skalides E, Kotsis V, Garoufi A, Athyros V, Kolovou G, Sfikas G, Bilianou E, Koutagiar I, Kiouri E, Agapakis D, Zacharis E, Antza C, Attilakos A, Katsiki N, Anagnostis P, Elisaf M, Liberopoulos E. Latest European guidelines for dyslipidemias in the setting of familial hypercholesterolemia: Data from the hellas-fh registry. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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25
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Karapostolakis G, Vakaki M, Attilakos A, Marmarinos A, Papadaki M, Koumanidou C, Alexopoulou E, Gourgiotis D, Garoufi A. The Effect of Long-Term Atorvastatin Therapy on Carotid Intima-Media Thickness of Children With Dyslipidemia. Angiology 2020; 72:322-331. [PMID: 33242982 DOI: 10.1177/0003319720975635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Carotid intima-media thickness (cIMT) has been proposed as an early marker of subclinical atherosclerosis in high risk children. Children with heterozygous familial hypercholesterolemia have greater cIMT than matched healthy controls or their unaffected siblings. Statin therapy may delay the progression of cIMT, although long-term studies in children are scarce. We evaluated the effect of atorvastatin treatment on cIMT in children with dyslipidemia. We studied 81 children/adolescents, 27 with severe dyslipidemia (low-density lipoprotein cholesterol [LDL-C] ≥190 mg/dL) and 54 sex- and age-matched healthy controls; LDL-C ≤ 130 mg/dL and lipoprotein (a), Lp(a), ≤30 mg/dL. In the children with dyslipidemia, cIMT was measured twice, before and on treatment (18.2 ± 7.7 months). Anthropometric data, a full lipid profile, liver, kidney, and thyroid function were evaluated. Males with dyslipidemia had a greater cIMT than male controls after adjustment for other factors (P = .049). In addition, a nonstatistically significant decrease in cIMT was observed after treatment (P = .261). Treatment with atorvastatin resulted in a significantly improved lipid profile. Females with dyslipidemia had a significantly thinner cIMT than males. Children with normal and high Lp(a) levels had similar cIMT values. In conclusion, treatment with atorvastatin had a beneficial effect on the lipid profile and cIMT progression in children with severe dyslipidemia.
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Affiliation(s)
| | - Marina Vakaki
- Radiology Department, "P. & A. Kyriakou" Childrens' Hospital, Athens, Greece
| | - Achilleas Attilakos
- Third Department of Pediatrics, Medical School, 68993National and Kapodistrian University of Athens, Attikon General Hospital, Chaidari, Athens, Greece
| | - Antonios Marmarinos
- Laboratory of Clinical Biochemistry - Molecular Diagnostic, Second Department of Pediatrics, Medical School, 68993National and Kapodistrian University of Athens, "P. & A. Kyriakou" Childrens' Hospital, Athens, Greece
| | - Maria Papadaki
- Outpatient Lipid Unit, Second Department of Pediatrics, Medical School, 68993National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | | | - Eftymia Alexopoulou
- Radiology Department, Medical School, Attikon General Hospital, 68993National and Kapodistrian University of Athens, Chaidari, Athens, Greece
| | - Dimitrios Gourgiotis
- Laboratory of Clinical Biochemistry - Molecular Diagnostic, Second Department of Pediatrics, Medical School, 68993National and Kapodistrian University of Athens, "P. & A. Kyriakou" Childrens' Hospital, Athens, Greece
| | - Anastasia Garoufi
- Outpatient Lipid Unit, Second Department of Pediatrics, Medical School, 68993National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
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26
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Mazzanti A, Guz D, Trancuccio A, Pagan E, Kukavica D, Chargeishvili T, Olivetti N, Biernacka EK, Sacilotto L, Sarquella-Brugada G, Campuzano O, Nof E, Anastasakis A, Sansone VA, Jimenez-Jaimez J, Cruz F, Sánchez-Quiñones J, Hernandez-Afonso J, Fuentes ME, Średniawa B, Garoufi A, Andršová I, Izquierdo M, Marinov R, Danon A, Expósito-García V, Garcia-Fernandez A, Muñoz-Esparza C, Ortíz M, Zienciuk-Krajka A, Tavazzani E, Monteforte N, Bloise R, Marino M, Memmi M, Napolitano C, Zorio E, Monserrat L, Bagnardi V, Priori SG. Natural History and Risk Stratification in Andersen-Tawil Syndrome Type 1. J Am Coll Cardiol 2020; 75:1772-1784. [PMID: 32299589 DOI: 10.1016/j.jacc.2020.02.033] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/25/2020] [Accepted: 02/11/2020] [Indexed: 11/25/2022]
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27
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Attilakos A, Fotis L, Dinopoulos A, Alexopoulos H, Theofilopoulou AV, Tzioufas AG, Mastroyianni S, Karalexi M, Garoufi A. Antiphospholipid and Antinuclear Antibodies in Children with Idiopathic Epilepsy: A 2-Year Prospective Study. J Clin Neurol 2020; 16:140-144. [PMID: 31942770 PMCID: PMC6974823 DOI: 10.3988/jcn.2020.16.1.140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND PURPOSE The high prevalence of antiphospholipid antibodies (aPL) and antinuclear antibodies (ANA) in patients with epilepsy may be associated with either the disease itself or the antiepileptic treatment. The purpose of this prospective study was to determine the prevalence of aPL and ANA in children with idiopathic epilepsy before and during treatment with antiepileptic drugs. METHODS aPL, including both anticardiolipin and anti-β2-glycoprotein I antibodies, and ANA statuses were determined in 40 healthy children, 30 children treated with sodium valproate (VPA) monotherapy, and 20 children treated with carbamazepine (CBZ) monotherapy before and at 6, 12, and 24 months after treatment initiation. RESULTS Fifteen children (50%) in the VPA-treated group and 7 (35%) in the CBZ-treated group showed positivity for aPL before treatment initiation, compared with only 4 of the 40 controls. Nine children (30%) in the VPA-treated group and 4 (20%) in the CBZ-treated group showed positivity for ANA before treatment initiation, compared with only 2 of the 40 controls. The subgroup analysis found nonsignificant associations at the different time points regarding the positivity of all of the autoantibodies. Only patients treated with VPA had a significantly decreased risk of aPL positivity after 6 months of treatment. CONCLUSIONS The increased prevalence of autoantibodies in children with idiopathic epilepsy is strongly associated with the disease itself.
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Affiliation(s)
- Achilleas Attilakos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece.
| | - Lambros Fotis
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Argirios Dinopoulos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Harris Alexopoulos
- Department of Pathophysiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Athanasios George Tzioufas
- Department of Pathophysiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotiria Mastroyianni
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Maria Karalexi
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Anastasia Garoufi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
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28
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Attilakos A, Dinopoulos A, Paschalidou M, Tsirouda M, Garoufi A. Monitoring of biochemical parameters and coagulation tests in children with epilepsy treated with levetiracetam monotherapy. Childs Nerv Syst 2019; 35:2033-2034. [PMID: 31152218 DOI: 10.1007/s00381-019-04225-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/23/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Achilleas Attilakos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece.
| | - Argirios Dinopoulos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Maria Paschalidou
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Maria Tsirouda
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Anastasia Garoufi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
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29
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Liberopoulos E, Rizos C, Garoufi A, Kolovou G, Athyros V, Skoumas I, Kotsis V, Rallidis L, Tziomalos K, Skalides E, Attilakos A, Katsiki N, Koutagiar I, Antza C, Elisaf M. P5324Children with familial hypercholesterolemia: lipid profile, treatment and evaluation of different formulas for calculating low-density lipoprotein cholesterol: an analysis from the HELLAS-FH registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
There is limited data on cardiometabolic characteristics and treatment of underage patients with familial hypercholesterolemia (FH). Accurate estimation of low-density lipoprotein cholesterol is essential to tailor hypolipidemic treatment.
Purpose
To report lipid profile and current treatment of underage patients with FH in Greece as recorded in the HELLAS-FH registry. Also, to compare the Friedewald with the Martin/Hopkins equation, (which provides a customized estimation of VLDL-C) and the Dahlen's formula [(which adjusts the LDL-C measurements for the amount of cholesterol in Lp(a)].
Methods
Underage patients with FH were evaluated. Lipid profile, current treatment regimen as well as LDL-C levels as assessed with different formulas were evaluated.
Results
A total of 191 children were included (51.0% boys, 11.0±3.5 years old). Children at baseline had mean LDL-C as calculated by the Friedewald equation (LDL-CF) 233±65 mg/dL and median Lp(a) 15.3 (IQR 8–51) mg/dL. A total of 59.2% of subjects were receiving hypolipidemic treatment, mainly statins (29.4%) and sterols/stanols (25.5%). Children on hypolipidemic therapy had mean LDL-CF 183±98 mg/dL with 22.1% achieving an LDL-C≤130 mg/dL. When LDL-C was calculated based on the Martin-Hopkins equation (LDL-CM/H) respective values were 180±58 mg/dL and 24.8%. When LDL-C was corrected for Lp(a) [= LDL-CM/H − (Lp(a) * 0.30)], LDL-C was 174±105 mg/dL with 33.3% of patients within the LDL-C target.
Conclusions
Nearly two-thirds of children were receiving some kind of hypolipidemic treatment at the time of registration. For those on treatment, LDL-C goal is achieved by one in five, which rises to 1 in 3 when LDL-C is corrected for Lp(a) levels.
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Affiliation(s)
- E Liberopoulos
- University of Ioannina, Department of Internal Medicine, Ioannina, Greece
| | - C Rizos
- University of Ioannina, Department of Internal Medicine, Ioannina, Greece
| | - A Garoufi
- General Children Hospital Pan. & Aglaia Kyriakou, 2nd Pediatrics Clinic, Athens, Greece
| | - G Kolovou
- Onassis Cardiac Surgery Center, Cardiology Clinic, Athens, Greece
| | - V Athyros
- Hippocration General Hospital of Thessaloniki, Department of Internal Medicine, Thessaloniki, Greece
| | - I Skoumas
- Hippokration General Hospital, Cardiology Clinic, Athens, Greece
| | - V Kotsis
- Hospital Papageorgiou, Department of Internal Medicine, Thessaloniki, Greece
| | - L Rallidis
- Attikon University Hospital, Department of Cardiology, Athens, Greece
| | - K Tziomalos
- Ahepa University Hospital, 1st Department of Propaedeutic Internal Medicine, Thessaloniki, Greece
| | - E Skalides
- University Hospital of Heraklion, Cardiology Clinic, Heraklion, Greece
| | - A Attilakos
- Attikon University Hospital, 3rd Pediatrics Clinic, Athens, Greece
| | - N Katsiki
- Hippocration General Hospital of Thessaloniki, Department of Internal Medicine, Thessaloniki, Greece
| | - I Koutagiar
- Hippokration General Hospital, Cardiology Clinic, Athens, Greece
| | - C Antza
- Hospital Papageorgiou, Department of Internal Medicine, Thessaloniki, Greece
| | - M Elisaf
- University of Ioannina, Department of Internal Medicine, Ioannina, Greece
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30
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Liberopoulos E, Rizos C, Skoumas I, Tziomalos K, Rallidis L, Kotsis V, Athyros V, Skalides E, Kolovou G, Garoufi A, Koutagiar I, Papagianni M, Kiouri E, Antza C, Elisaf M. P5321The association of Lp(a) levels and cardiovascular disease in adult patients with familial hypercholesterolemia: analysis from the HELLAS-FH registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Familial hypercholesterolemia (FH) as well as elevated Lp(a) levels are both associated with increased cardiovascular disease (CVD) risk. There are limited data on the association of Lp(a) levels with CVD in FH Patients.
Purpose
To evaluate the association between Lp(a) levels and CVD in adult FH patients included in the HELLAS-FH registry in Greece.
Methods
Adult patients with FH and measured Lp(a) levels were included in this analysis. Demographics, CVD prevalence and lipid profile were evaluated.
Results
A total of 337 patients were evaluated (46% male, 48.3±15.4 years old). The median [IQR] of Lp(a) at baseline was 22.6 (9.7–56.2) mg/dL. Patients were categorized into 4 different groups according to the Lp(a) levels quartiles. There was no gender or age difference between the 4 groups. Moreover, all groups had similar smoking status, hypertension, body mass index and type 2 diabetes prevalence. There was no significant difference between groups regarding baseline and on treatment lipid profile. We observed a significant positive association between Lp(a) quartile and coronary artery disease (CAD) prevalence (p=0.004). Patients in the highest vs lowest quartile had greater CAD prevalence (21.7% vs 7%, p=0.006). No association was observed between Lp(a) quartile and the prevalence of cerebrovascular disease or peripheral artery disease.
Conclusions
Elevated Lp(a) levels have a positive correlation with CAD in patients with FH.
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Affiliation(s)
- E Liberopoulos
- University of Ioannina, Department of Internal Medicine, Ioannina, Greece
| | - C Rizos
- University of Ioannina, Department of Internal Medicine, Ioannina, Greece
| | - I Skoumas
- Hippokration General Hospital, Cardiology Clinic, Athens, Greece
| | - K Tziomalos
- Ahepa University Hospital, 1st Department of Propaedeutic Internal Medicine, Thessaloniki, Greece
| | - L Rallidis
- Attikon University Hospital, Department of Cardiology, Athens, Greece
| | - V Kotsis
- Hospital Papageorgiou, Department of Internal Medicine, Thessaloniki, Greece
| | - V Athyros
- Hippocration General Hospital of Thessaloniki, Department of Internal Medicine, Thessaloniki, Greece
| | - E Skalides
- University Hospital of Heraklion, Cardiology Clinic, Heraklion, Greece
| | - G Kolovou
- Onassis Cardiac Surgery Center, Cardiology Clinic, Athens, Greece
| | - A Garoufi
- General Children Hospital Pan. & Aglaia Kyriakou, 2nd Pediatrics Clinic, Athens, Greece
| | - I Koutagiar
- Hippokration General Hospital, Cardiology Clinic, Athens, Greece
| | - M Papagianni
- Ahepa University Hospital, 1st Department of Propaedeutic Internal Medicine, Thessaloniki, Greece
| | - E Kiouri
- Attikon University Hospital, Department of Cardiology, Athens, Greece
| | - C Antza
- Hospital Papageorgiou, Department of Internal Medicine, Thessaloniki, Greece
| | - M Elisaf
- University of Ioannina, Department of Internal Medicine, Ioannina, Greece
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31
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Rizos C, Garoufi A, Elisaf M, Kolovou G, Athyros V, Skoumas I, Kotsis V, Rallidis L, Tziomalos K, Skalides E, Attilakos A, Katsiki N, Koutagiar I, Antza C, Kiouri E, Papagianni M, Loulakakis M, Liberopoulos E. Children With Familial Hypercholesterolemia: Cardiometabolic Profile Data From The Hellas-Fh Registry. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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32
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Rizos C, Elisaf M, Skoumas I, Tziomalos K, Rallidis L, Kotsis V, Athyros V, Skalides E, Kolovou G, Garoufi A, Koutagiar I, Papagianni M, Kiouri E, Antza C, Katsiki N, Zacharis E, Attilakos A, Liberopoulos E. Cardiovascular Disease And Lp(A) Levels In Adult Patients With Familial Hydrocholesterolemia. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rizos C, Elisaf M, Skoumas I, Tziomalos K, Rallidis L, Kotsis V, Athyros V, Skalides E, Kolovou G, Garoufi A, Florentin M, Koutagiar I, Papagianni M, Kiouri E, Antza C, Katsiki N, Zacharis E, Attilakos A, Liberopoulos E. Adults With Familial Hydrocholesterolemia: Latest Update On Cardiometabolic Profile From The Hellas-Fh Registry. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Attilakos A, Dinopoulos A, Tsirouda M, Paschalidou M, Prasouli A, Stamati A, Parasxou N, Garoufi A. Effect of levetiracetam monotherapy on lipid profiles and thyroid hormones in children with epilepsy: A prospective study. Epilepsy Res 2019; 155:106162. [PMID: 31301589 DOI: 10.1016/j.eplepsyres.2019.106162] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/24/2019] [Accepted: 07/03/2019] [Indexed: 01/24/2023]
Abstract
Long-term treatment with some older antiepileptic drugs may lead to dyslipidemia or thyroid disturbances. The effect of levetiracetam (LEV), a newer broad spectrum antiepileptic agent, on cardiovascular risk factors is not yet sufficiently investigated. The purpose of this study was to investigate prospectively the effect of LEV monotherapy on serum lipid profile and thyroid hormones levels in children with epilepsy. The study population consisted of 39 children (21 females, 18 males, mean age 6.8 ± 4,1 years, range 2-15 years) that were treated for new-onset epilepsy with LEV monotherapy. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), apolipoprotein A-I (apo A-I), apolipoprotein B (apo B), lipoprotein (a) [Lp(a)], thyroxine (T4), free thyroxine (FT4) and thyrotropin (TSH), were evaluated before and at 6 and 12 (n = 28) months of LEV monotherapy. TGs were significantly decreased at 6 and 12 months of LEV treatment (p = 0.026 and p = 0.001, respectively). TGs/HDL-C ratio was significantly decreased at 6 and 12 months of LEV treatment (p = 0.024 and p = 0.003, respectively), while LDL-C/HDL-C ratio was significantly decreased at 12 months of LEV treatment (p = 0.025). There were no significant alterations in the other parameters during the study. In conclusion, long-term LEV monotherapy does not cause adverse alterations on thyroid hormones and serum lipids in children with epilepsy. More studies are needed to clarify whether LEV monotherapy have a favourable effect on serum lipids and whether LEV may be considered as a safer alternative drug for the prevention of antiepileptic drug-induced cardiovascular complications in adult life.
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Affiliation(s)
- Achilleas Attilakos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece.
| | - Argirios Dinopoulos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Maria Tsirouda
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Maria Paschalidou
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Alexia Prasouli
- Department of Social and Developmental Pediatrics, Institute of Child Health, Athens, Greece
| | - Adiana Stamati
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital Athens, Greece
| | - Nefeli Parasxou
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital Athens, Greece
| | - Anastasia Garoufi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital Athens, Greece
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Attilakos A, Paschalidou M, Garoufi A, Tsirouda M, Papadopoulou A, Karalexi M, Dinopoulos A. Short-Term and Long-Term Effects of Levetiracetam Monotherapy on Homocysteine Metabolism in Children with Epilepsy: A Prospective Study. J Clin Neurol 2019; 15:149-151. [PMID: 30938107 PMCID: PMC6444148 DOI: 10.3988/jcn.2019.15.2.149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 12/05/2022] Open
Abstract
Background and Purpose Long-term treatment with some older antiepileptic drugs may lead to hyperhomocysteinemia. Levetiracetam (LEV) is a newer broad-spectrum antiepileptic agent whose effects on homocysteine concentrations remain unclear. The purpose of this study was to prospectively determine the short-term and long-term effects of LEV monotherapy on homocysteine metabolism in children with epilepsy. Methods The study population consisted of 32 children [18 females, 14 males; age 5.94±4.10 years (mean±SD), age range 1–15 years] who received LEV monotherapy for new-onset epilepsy. Serum folate, serum vitamin B12, and plasma total homocysteine (p-tHcy) were measured before and at 2 months (n=32), 6 months (n=25), and 12 months (n=18) of LEV monotherapy. Results p-tHcy was significantly decreased at 2 months of treatment (p=0.031). Furthermore, analysis of covariance showed statistically significant decreases in p-tHcy at 2 months (p=0.013) and 6 months (p=0.015) of LEV treatment after controlling for age, sex, body mass index, and LEV dose. There were no significant alterations in the other parameters during the study. The drug doses were 18.1±7.1, 20.1±9.2, and 21.2±11.8 mg/kg at 2, 6, and 12 months of LEV treatment, respectively. Conclusions In contrast with older antiepileptic drugs, long-term LEV monotherapy in children with epilepsy does not cause adverse alterations on homocysteine metabolism. Larger prospective studies are needed to definitively clarify whether LEV may be considered a safer alternative drug for preventing antiepileptic-drug-induced cardiovascular complications in adult life.
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Affiliation(s)
- Achilleas Attilakos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, Greece
| | - Maria Paschalidou
- Third Department of Pediatrics, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, Greece
| | - Anastasia Garoufi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, “P&A Kyriakou” Children's Hospital, Athens, Greece
| | - Maria Tsirouda
- Third Department of Pediatrics, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, Greece
| | - Anna Papadopoulou
- Third Department of Pediatrics, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, Greece
| | - Maria Karalexi
- Third Department of Pediatrics, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, Greece
| | - Argirios Dinopoulos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, Greece
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Attilakos A, Tsirouda M, Dinopoulos A, Garoufi A. Vitamin D status in children with epilepsy treated with levetiracetam monotherapy. Epilepsy Res 2018; 148:116. [DOI: 10.1016/j.eplepsyres.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 11/24/2022]
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Attilakos A, Dinopoulos A, Paschalidou M, Tsirouda M, Prasouli A, Siafakas N, Garoufi A. Effect of Levetiracetam Monotherapy on Liver Enzymes and Creatine Kinase Concentrations in Children with Epilepsy: A Prospective Study. J Clin Neurol 2018; 14:594-595. [PMID: 30284772 PMCID: PMC6172492 DOI: 10.3988/jcn.2018.14.4.594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Achilleas Attilakos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece.
| | - Argirios Dinopoulos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Maria Paschalidou
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Maria Tsirouda
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Alexia Prasouli
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Nikos Siafakas
- Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece
| | - Anastasia Garoufi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
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Rizos CV, Elisaf MS, Skoumas I, Tziomalos K, Kotsis V, Rallidis L, Garoufi A, Athyros VG, Skalidis E, Kolovou G, Koutagiar I, Papagianni M, Antza C, Katsiki N, Ganotakis E, Liberopoulos EN. Characteristics and management of 1093 patients with clinical diagnosis of familial hypercholesterolemia in Greece: Data from the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH). Atherosclerosis 2018; 277:308-313. [DOI: 10.1016/j.atherosclerosis.2018.08.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 07/15/2018] [Accepted: 08/21/2018] [Indexed: 01/07/2023]
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Attilakos A, Garoufi A, Paschalidou M, Tsirouda M, Siafakas N, Dinopoulos A. Serum sodium, potassium, and magnesium in children with epilepsy treated with levetiracetam monotherapy: A prospective study. CNS Neurosci Ther 2018; 24:846-847. [DOI: 10.1111/cns.12868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/31/2018] [Accepted: 04/02/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Achilleas Attilakos
- Third Department of Pediatrics; National and Kapodistrian University of Athens; “Attikon” Hospital; Athens Greece
| | - Anastasia Garoufi
- Second Department of Pediatrics; National and Kapodistrian University of Athens; “Panagiotis and Aglaia Kyriakou” Children's Hospital Athens; Athens Greece
| | - Maria Paschalidou
- Third Department of Pediatrics; National and Kapodistrian University of Athens; “Attikon” Hospital; Athens Greece
| | - Maria Tsirouda
- Third Department of Pediatrics; National and Kapodistrian University of Athens; “Attikon” Hospital; Athens Greece
| | - Nikos Siafakas
- Third Department of Pediatrics; National and Kapodistrian University of Athens; “Attikon” Hospital; Athens Greece
| | - Argiris Dinopoulos
- Third Department of Pediatrics; National and Kapodistrian University of Athens; “Attikon” Hospital; Athens Greece
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Garoufi A, Marmarinos A, Vraila VM, Dimou S, Pagoni A, Vorre S, Paraskakis I, Gourgiotis D. Influence of hypercholesterolemia on serum antibodies against oxidized LDL in children and adolescents. Pediatr Int 2018; 60:287-293. [PMID: 29297961 DOI: 10.1111/ped.13501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 11/21/2017] [Accepted: 12/26/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The oxidation of low-density lipoprotein (LDL; oxLDL) appears to play a key role in the early development of atherosclerosis. Increased serum antibodies against the oxLDL (anti-oxLDL antibodies) have been found in adults with atherosclerotic disease, as well as in healthy adults. The clinical significance and its precise role (atherogenic or atheroprotective), however, have not yet been clarified. This aim of this study was therefore to evaluate anti-oxLDL antibodies in healthy children and adolescents with and without hypercholesterolemia. METHODS The study involved 312 subjects, aged 4-18 years, 141 with LDL cholesterol (LDL-C) ≥130 mg/dL and 171 with acceptable LDL-C (<110 mg/dL). Total anti-oxLDL antibodies, total cholesterol, LDL-C and high-density lipoprotein cholesterol, triglycerides, apolipoproteins A1 and B, lipoprotein (a) and high-sensitivity C-reactive protein were measured in fasting serum. The anti-oxLDL antibodies were measured on enzyme-linked immunosorbent assay. RESULTS Anti-oxLDL antibodies were similar in the hypercholesterolemia and non-hypercholesterolemia groups. Girls had significantly higher anti-oxLDL antibodies compared with boys. There was no significant correlation of antibodies with age or body mass index. Increased apolipoprotein B was an important factor for lower anti-oxLDL antibodies, while all other parameters had no significant association with anti-oxLDL antibodies. CONCLUSION In children and adolescents with hypercholesterolemia, total anti-oxLDL antibodies cannot serve as a marker for risk for atherosclerosis or for future cardiovascular disease.
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Affiliation(s)
- Anastasia Garoufi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, P & A Kyriakou Children's Hospital, Athens, Attica, Greece
| | - Antonios Marmarinos
- Laboratory of Clinical Biochemistry-Molecular Diagnostics, National and Kapodistrian University of Athens, Medical School, P & A Kyriakou Children's Hospital, Athens, Attica, Greece
| | - Venetia-Maria Vraila
- Laboratory of Clinical Biochemistry-Molecular Diagnostics, National and Kapodistrian University of Athens, Medical School, P & A Kyriakou Children's Hospital, Athens, Attica, Greece
| | - Stamatina Dimou
- Biochemistry Laboratory, Department of Clinical Biochemistry, P & A Kyriakou Children's Hospital, Athens, Attica, Greece
| | - Athanasia Pagoni
- Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, P & A Kyriakou Children's Hospital, Athens, Attica, Greece
| | - Styliani Vorre
- Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, P & A Kyriakou Children's Hospital, Athens, Attica, Greece
| | - Irene Paraskakis
- Department of Clinical Microbiology, P & A Kyriakou Children's Hospital, Athens, Attica, Greece
| | - Dimitrios Gourgiotis
- Laboratory of Clinical Biochemistry-Molecular Diagnostics, National and Kapodistrian University of Athens, Medical School, P & A Kyriakou Children's Hospital, Athens, Attica, Greece
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Pisciotta L, Tozzi G, Travaglini L, Taurisano R, Lucchi T, Indolfi G, Papadia F, Di Rocco M, D'Antiga L, Crock P, Vora K, Nightingale S, Michelakakis H, Garoufi A, Lykopoulou L, Bertolini S, Calandra S. Molecular and clinical characterization of a series of patients with childhood-onset lysosomal acid lipase deficiency. Retrospective investigations, follow-up and detection of two novel LIPA pathogenic variants. Atherosclerosis 2017; 265:124-132. [PMID: 28881270 DOI: 10.1016/j.atherosclerosis.2017.08.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 08/05/2017] [Accepted: 08/22/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Childhood/Adult-onset Lysosomal Acid Lipase Deficiency (LAL-D) is a recessive disorder due to loss of function variants of LAL, the enzyme which hydrolyses cholesteryl esters, derived from internalized apoB containing lipoproteins. The disease is characterized by multi-organ involvement including the liver, spleen, intestine and cardiovascular system. The aim of this study was the clinical and molecular characterization of 14 (13 unrelated) previously unreported patients with childhood-onset LAL-D. METHODS Data collected included clinical and laboratory investigations, liver imaging, liver biopsy and LIPA gene analysis. The response to lipid-lowering medications, liver transplantation and enzyme replacement therapy (ERT) was reported for some patients. RESULTS LAL-D was suspected at 4.4 ± 3.3 years of age for the presence of hepatomegaly, elevated serum transaminases and hypercholesterolemia, and was confirmed by liver biopsy/imaging and LAL assay. The follow up period ranged from 3 to 40 years (mean 7.8 ± 4.0 years in 13 cases). Patients treated with statins with or without ezetimibe showed 28% reduction of plasma LDL-cholesterol without a tangible effect on liver enzymes; some patients receiving ERT showed normalized lipoprotein profile and transaminase levels. The common c.894G > A variant was observed in homozygosity or compound heterozygosity in 10 patients. We found seven previously reported variants: p.(Trp140*), p.(Arg218*), p.(Gly266*), p.(Thr288Ile), p.(Leu294Ser), p.(His295Tyr) and p.(Gly342Arg) and two novel variants: p.(Asp345Asn), affecting the LAL catalytic triad, and c.229+3A > C, affecting splicing. Homozygosity for p.(Thr288Ile) or c.229+3A > C was associated with a severe phenotype. CONCLUSIONS This study provides additional data on the features of childhood-onset LAL-D and describes two novel pathogenic variants of the LIPA gene.
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Affiliation(s)
| | - Giulia Tozzi
- Laboratory of Molecular Medicine, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lorena Travaglini
- Laboratory of Molecular Medicine, Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Roberta Taurisano
- Metabolism Division, Department of Pediatrics Specialist, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Tiziano Lucchi
- Department of Internal Medicine and Medical Specialities, IRCSS Ca' Granda, Milan, Italy
| | - Giuseppe Indolfi
- Paediatric and Liver Unit, Meyer Children's University-Hospital, Florence, Italy
| | - Francesco Papadia
- University Pediatric Hospital Giovanni XXIII, O.U. Metabolic and Genetic Diseases, Bari, Italy
| | - Maja Di Rocco
- IRCCS Institute Giannina Gaslini, Department of Pediatrics, Unit of Rare Diseases, Genoa, Italy
| | - Lorenzo D'Antiga
- Pediatric Department, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Patricia Crock
- John Hunter Children Hospital, Discipline of Paediatrics and Child Health, University of Newcastle, Newcastle, Australia
| | - Komal Vora
- John Hunter Children Hospital, Discipline of Paediatrics and Child Health, University of Newcastle, Newcastle, Australia
| | - Scott Nightingale
- John Hunter Children Hospital, Discipline of Paediatrics and Child Health, University of Newcastle, Newcastle, Australia
| | - Helen Michelakakis
- Department of Enzymology and Cellular Function, Institute of Child Health, Athens, Greece
| | - Anastasia Garoufi
- 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | - Lilia Lykopoulou
- 1st Department of Pediatrics, University of Athens, Aghia Sofia Children's Hospital, Athens, Greece
| | | | - Sebastiano Calandra
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy.
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Rizos CV, Athyros V, Bilianou E, Chrousos G, Garoufi A, Kolovou G, Kotsis V, Rallidis L, Skalidis E, Skoumas I, Tziomalos K, Liberopoulos EN. An insight into familial hypercholesterolemia in Greece: rationale and design of the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH). Hormones (Athens) 2017; 16:200-204. [PMID: 29278517 DOI: 10.14310/horm.2002.1749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 11/05/2017] [Indexed: 11/20/2022]
Abstract
Familial hypercholesterolemia (FH) is the most common metabolic genetic disorder. It is estimated that around 13 million people worldwide have FH. At the same time, only 25% of FH patients have been diagnosed. Moreover, these patients are often undertreated. The true prevalence of FH in Greece is unknown, but it is estimated that there are at least 40,000 FH patients nationwide pointing to a prevalence of 1:250. Patients with FH are at a high risk for cardiovascular events and death at an early age. Therefore, prompt detection of these patients is of pivotal importance in order to implement appropriate preventive measures at a young age. Patient registries are a powerful tool for recording and monitoring a disease and promoting clinical practices, thus contributing to improved outcomes and reduction of healthcare costs. National registries of FH patients have been a success in the Netherlands, Spain and Wales. As Greece did not have a national FH registry, the Hellenic Atherosclerosis Society has organized, established and funded the Hellenic Familial Hypercholesterolemia (HELLAS-FH) national registry in order to promote a better understanding of FH in our country.
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Affiliation(s)
- Christos V Rizos
- Department of Internal Medicine, University of Ioannina Medical School, University Hospital of Ioannina, Ioannina, Greece
| | - Vasilios Athyros
- Department of Internal Medicine, Aristotle University of Thessaloniki Medical School, Hippokration Hospital, Thessaloniki, Greece
| | - Eleni Bilianou
- Department of Cardiology, Tzaneio Hospital, Piraeus, Greece
| | - George Chrousos
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, St. Sophia Children Hospital, Athens, Greece
| | - Anastasia Garoufi
- Second Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "P. and A. Kyriakou" Children's Hospital, Athens, Greece
| | - Genovefa Kolovou
- Department of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece
| | - Vasilios Kotsis
- Department of Internal Medicine, Aristotle University of Thessaloniki Medical School, Papageorgiou Hospital, Thessaloniki, Greece
| | - Loukianos Rallidis
- Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Emmanouel Skalidis
- Department of Cardiology, University Hospital of Heraklion, Heraklion, Greece
| | - Ioannis Skoumas
- Department of Cardiology, Hippokration Hospital, Athens, Greece
| | - Konstantinos Tziomalos
- First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki Medical School, AHEPA Hospital, Thessaloniki, Greece
| | - Evangelos N Liberopoulos
- Department of Internal Medicine, University of Ioannina Medical School, University Hospital of Ioannina, Ioannina, Greece
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Rizos CV, Athyros V, Bilianou E, Chrousos G, Garoufi A, Kolovou G, Kotsis V, Rallidis L, Skalidis E, Skoumas I, Tziomalos K, Liberopoulos EN. An insight into familial hypercholesterolemia in Greece: rationale and design of the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH). Hormones (Athens) 2017; 16:306-312. [PMID: 30091117 DOI: 10.1007/bf03401525] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 11/05/2017] [Indexed: 11/26/2022]
Abstract
Familial hypercholesterolemia (FH) is the most common metabolic genetic disorder. It is estimated that around 13 million people worldwide have FH. At the same time, only 25% of FH patients have been diagnosed. Moreover, these patients are often undertreated. The true prevalence of FH in Greece is unknown, but it is estimated that there are at least 40,000 FH patients nationwide pointing to a prevalence of 1:250. Patients with FH are at a high risk for cardiovascular events and death at an early age. Therefore, prompt detection of these patients is of pivotal importance in order to implement appropriate preventive measures at a young age. Patient registries are a powerful tool for recording and monitoring a disease and promoting clinical practices, thus contributing to improved outcomes and reduction of healthcare costs. National registries of FH patients have been a success in the Netherlands, Spain and Wales. As Greece did not have a national FH registry, the Hellenic Atherosclerosis Society has organized, established and funded the Hellenic Familial Hypercholesterolemia (HELLAS-FH) national registry in order to promote a better understanding of FH in our country.
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Affiliation(s)
- Christos V Rizos
- Department of Internal Medicine, University of Ioannina Medical School, University Hospital of Ioannina, 45110, Ioannina, Greece
| | - Vasilios Athyros
- Department of Internal Medicine, Aristotle University of Thessaloniki Medical School Hippokration Hospital, Thessaloniki, Greece
| | - Eleni Bilianou
- Department of Cardiology, Tzaneio Hospital, Piraeus, Greece
| | - George Chrousos
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, St. Sophia Children Hospital, Athens, Greece
| | - Anastasia Garoufi
- Second Department of Pediatrics, Medical School, National & Kapodistrian University of Athens "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | - Genovefa Kolovou
- Department of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece
| | - Vasilios Kotsis
- Department of Internal Medicine, Aristotle University of Thessaloniki Medical School, Papageorgiou Hospital, Thessaloniki, Greece
| | - Loukianos Rallidis
- Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Emmanouel Skalidis
- Department of Cardiology, University Hospital of Heraklion, Heraklion, Greece
| | - Ioannis Skoumas
- Department of Cardiology, Hippokration Hospital, Athens, Greece
| | - Konstantinos Tziomalos
- First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki Medical School, AHEPA Hospital, Thessaloniki, Greece
| | - Evangelos N Liberopoulos
- Department of Internal Medicine, University of Ioannina Medical School, University Hospital of Ioannina, 45110, Ioannina, Greece.
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Tsotra K, Garoufi A, Kossiva L, Gourgiotis D, Tsoukatou T, Katsantoni E, Stavropoulos P. The impact of vitamin D supplementation on serum cathelicidin levels and the clinical course of atopic dermatitis in children. Minerva Pediatr 2017. [PMID: 28643993 DOI: 10.23736/s0026-4946.17.04910-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cathelicidin has been correlated with the pathophysiology of atopic dermatitis (AD). An indirect correlation of vitamin D with the course of the disease has already been reported as it directly affects the levels of cathelicidin. The purpose of the present article is to investigate the impact of vitamin D supplementation on the course of AD. METHODS We conducted a prospective observational study. The severity of AD was assessed with the clinical tool SCORAD (SCORing Atopic Dermatitis) which is developed by the European Task Force on AD. RESULTS Fifty children with AD were enrolled and stratified in two groups based on the severity of SCORAD. Children with severe AD (SCORAD index> 40) received higher doses of vitamin D in order to sufficiently reduce the disease (comparable index SCORAD children with mild atopic dermatitis). While the baseline SCORAD differed statistically significant level between the two groups of children with AD (p <.001) this difference disappeared at 20 (p = .649) days and remained statistically insignificant both at 45 days (p = .610), and at the end of the administration of treatment (p = .474) (Table). This effect was based on a significant downregulation of the severity of symptoms in the group of children that received 2400 IU of vitamin D. CONCLUSIONS The findings of our study suggest that vitamin D may be accurately used in current clinical practice for the management of AD. However, the recommended dose should be titrated taking in mind the severity of the disease.
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Affiliation(s)
- Kyriaki Tsotra
- Second Department of Pediatrics, Aglaia Kyriakou University Hospital, National and Kapodistrian University of Athens, Athens, Greece -
| | - Anastasia Garoufi
- Second Department of Pediatrics, Aglaia Kyriakou University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Lydia Kossiva
- Second Department of Pediatrics, Aglaia Kyriakou University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Gourgiotis
- Laboratory of Clinical Biochemistry-Molecular Diagnosis, Aglaia Kyriakou University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Theano Tsoukatou
- Second Department of Pediatrics, Aglaia Kyriakou University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Katsantoni
- Basic Research Center, Biomedical Research Foundation, Academy of Athens, Athens, Greece
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Garoufi A, Grammatikos EE, Kollias A, Grammatikos E, Stergiou GS, Soldatou A. Associations between obesity, adverse behavioral patterns and cardiovascular risk factors among adolescent inhabitants of a Greek island. J Pediatr Endocrinol Metab 2017; 30:445-454. [PMID: 28315850 DOI: 10.1515/jpem-2016-0134] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 01/16/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Excess weight, unhealthy lifestyle habits and their sequelae have become a well-recognized public health problem in most countries. The objective of the study was to examine the relationship of adolescent overweight/obesity with behavioral habits and their association with blood pressure (BP) and lipid profile. METHODS Anthropometric parameters, lifestyle, BP and lipid profile of 736 adolescents were evaluated cross-sectionally. The classifications of normal weight, overweight and obese were based on BMI z-scores. RESULTS About 42.1% of adolescents were overweight/obese, 11.3% were smokers, 33.2% consumed alcohol and 34% reported low activity. Males began smoking earlier, consumed alcohol more often, exercised less and spent more screen time than females. Alcohol consumption was more prevalent among smokers and was associated with higher BP and dyslipidemia. Smokers exercised less intensely and had lower high density lipoprotein-cholesterol (HDL-C) than non-smokers. Obesity was a risk factor for higher BP and dyslipidemia. Longer screen time was associated with higher triglycerides, while intense physical activity with lower systolic BP. CONCLUSIONS Obesity is related to an adverse lipid and BP profile during adolescence. Clustering of hazardous habits was observed, which is known to aggravate the cardiovascular risk.
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Affiliation(s)
- Anastasia Garoufi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens
| | - Evangelos E Grammatikos
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens
| | - Anastasios Kollias
- Hypertension Center STRIDE-7, Third University Department of Medicine, Sotiria Hospital, Athens
| | | | - George S Stergiou
- Hypertension Center STRIDE-7, Third University Department of Medicine, Sotiria Hospital, Athens
| | - Alexandra Soldatou
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens
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Garoufi A, Drapanioti S, Marmarinos A, Askiti V, Mitsioni AJ, Mila M, Grigoriadou G, Georgakopoulos D, Stefanidis CJ, Gourgiotis D. Plasma Urotensin II levels in children and adolescents with chronic kidney disease: a single-centre study. BMC Nephrol 2017; 18:113. [PMID: 28359257 PMCID: PMC5374664 DOI: 10.1186/s12882-017-0530-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 03/24/2017] [Indexed: 02/07/2023] Open
Abstract
Background Increased plasma Urotensin II (UII) levels have been found in adults with renal diseases. Studies in children are scarce. The objective of the study is to estimate plasma UII levels in subjects with chronic kidney disease (CKD) stages 3 to 5 and renal transplant recipients (RTR). In addition, the correlation of UII with anthropometric features and biochemical parameters was assessed. Methods Fifty-four subjects, aged 3 to 20 years old, 23 with CKD, 13 with end-stage kidney disease (ESKD) undergoing hemodialysis (HD) and 18 RTR were enrolled. A detailed clinical evaluation was performed. Biochemical parameters of renal and liver function were measured. Plasma UII levels were measured in all patients and in 117 healthy controls, using a high sensitive enzyme immunoassay (EIA) kit. All data were analyzed using STATA™ (Version 10.1). Results Median UII and mean log-transformed UII levels were significantly higher in CKD and RTR patients compared to healthy subjects (p < 0.001). HD patients had higher but not statistically significant UII and log-UII levels than controls. UII levels increased significantly at the end of the HD session and were higher than controls and in line to those of other patients. The geometric scores of UII in HD (before dialysis), CKD and RTR patients increased respectively by 42, 136 and 164% in comparison with controls. Metabolic acidosis was associated with statistical significant change in log-UII levels (p = 0.001). Patients with metabolic acidosis had an increase in UII concentration by 76% compared to those without acidosis. Conclusions Children and adolescents with CKD, particularly those who are not on HD and RTR, have significantly higher levels of UII than healthy subjects. UII levels increase significantly at the end of the HD session. The presence of metabolic acidosis affects significantly plasma UII levels.
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Affiliation(s)
- Anastasia Garoufi
- Second Department of Pediatrics, Medical School, National and Kapodistrian University of Athens,"P. & A. Kyriakou" Childrens' Hospital, Thivon & Levadias str, 11527, Athens, Greece.
| | - Styliani Drapanioti
- Second Department of Pediatrics, Medical School, National and Kapodistrian University of Athens,"P. & A. Kyriakou" Childrens' Hospital, Thivon & Levadias str, 11527, Athens, Greece
| | - Antonios Marmarinos
- Laboratory of Clinical Biochemistry - Molecular Diagnostic, Medical School, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Childrens' Hospital, Thivon & Levadias str, 11527, Athens, Greece
| | - Varvara Askiti
- Department of Nephrology, "P. & A. Kyriakou" Childrens' Hospital, Thivon & Levadias str, 11527, Athens, Greece
| | - Andromachi J Mitsioni
- Department of Nephrology, "P. & A. Kyriakou" Childrens' Hospital, Thivon & Levadias str, 11527, Athens, Greece
| | - Maria Mila
- Department of Nephrology, "P. & A. Kyriakou" Childrens' Hospital, Thivon & Levadias str, 11527, Athens, Greece
| | | | | | - Constantinos J Stefanidis
- Department of Nephrology, "P. & A. Kyriakou" Childrens' Hospital, Thivon & Levadias str, 11527, Athens, Greece
| | - Dimitrios Gourgiotis
- Laboratory of Clinical Biochemistry - Molecular Diagnostic, Medical School, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Childrens' Hospital, Thivon & Levadias str, 11527, Athens, Greece
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Maritsi DN, Vartzelis G, Kossiva L, Vougiouka O, Garoufi A. The response to the inactivated Hepatitis A vaccine in children with autoinflammatory diseases: a prospective observational controlled study: Table 1. Rheumatology (Oxford) 2016; 55:1705-6. [DOI: 10.1093/rheumatology/kew239] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2016] [Indexed: 11/13/2022] Open
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Garoufi A, Vartzelis G, Tsentidis C, Attilakos A, Koemtzidou E, Kossiva L, Katsarou E, Soldatou A. Weight gain in children on oxcarbazepine monotherapy. Epilepsy Res 2016; 122:110-3. [PMID: 27010568 DOI: 10.1016/j.eplepsyres.2016.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 02/12/2016] [Accepted: 03/12/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Studies of the effect of oxcarbazepine (OXC) on body growth of children with epilepsy are rare and their results are controversial. To the contrary, many studies have shown significant weight gain following valproate (VPA) treatment. PURPOSE To prospectively evaluate the effect of OXC monotherapy on growth patterns of children with epilepsy and compare it with the effect of VPA monotherapy. METHOD Fifty-nine otherwise healthy children, aged 3.7-15.9 years, with primary generalized, partial or partial with secondary generalization seizure disorder, were included in the study. Twenty six children were placed on OXC and thirty three on VPA monotherapy. Body weight (BW), height and body mass index (BMI) as well as their standard deviation scores (SDS), were evaluated prior to as well as 8 months post initiation of OXC or VPA therapy. RESULTS Eight months post OXC-treatment, BW, SDS-BW, BMI and SDS-BMI increased significantly. The increase was similar to that observed in the VPA group. An additional 15.4% of children in the OXC group and 21.2% in the VPA group became overweight or obese. The effect of both OXC and VPA therapy on linear growth did not reach statistical significance. CONCLUSION Similarly to VPA, OXC monotherapy resulted in a significant weight gain in children with epilepsy. Careful monitoring for excess weight gain along with counseling on adapting a healthy lifestyle should be offered to children on OXC therapy.
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Affiliation(s)
- Anastasia Garoufi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, 'P. & A. Kyriakou' Children's Hospital, Thivon & Levadias Str., 11527 Athens, Greece.
| | - George Vartzelis
- Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, 'P. & A. Kyriakou' Children's Hospital, Thivon & Levadias Str., 11527 Athens, Greece
| | - Charalambos Tsentidis
- Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, 'P. & A. Kyriakou' Children's Hospital, Thivon & Levadias Str., 11527 Athens, Greece
| | - Achilleas Attilakos
- Third Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, Attikon Hospital, Rimini 1, 12462, Haidari, Athens, Greece
| | - Evangelia Koemtzidou
- Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, 'P. & A. Kyriakou' Children's Hospital, Thivon & Levadias Str., 11527 Athens, Greece
| | - Lydia Kossiva
- Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, 'P. & A. Kyriakou' Children's Hospital, Thivon & Levadias Str., 11527 Athens, Greece
| | - Eustathia Katsarou
- Department of Pediatric Neurology, 'P. & A. Kyriakou' Children's Hospital, Thivon & Levadias Str., 11527, Athens, Greece
| | - Alexandra Soldatou
- Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, 'P. & A. Kyriakou' Children's Hospital, Thivon & Levadias Str., 11527 Athens, Greece
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Marmarinos A, Garoufi A, Panagoulia A, Dimou S, Drakatos A, Paraskakis I, Gourgiotis D. Cystatin-C levels in healthy children and adolescents: Influence of age, gender, body mass index and blood pressure. Clin Biochem 2016; 49:150-3. [DOI: 10.1016/j.clinbiochem.2015.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 10/12/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022]
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Kapitsinou A, Soldatou A, Tsitsika A, Kossiva L, Tsentidis C, Nisianakis P, Theocharis S, Garoufi A. Risk factors for elevated blood lead levels among children aged 6-36 months living in Greece. Child Care Health Dev 2015; 41:1199-206. [PMID: 25968465 DOI: 10.1111/cch.12254] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Childhood lead poisoning remains a critical environmental health concern because even low blood lead levels (BLLs) can result in permanent adverse health effects. Social factors and living conditions have been correlated with BLLs. There is no recent survey about the prevalence of elevated BLLs among children in Greece. The purpose of this study was to assess BLLs among children aged 6-36 months born and living in Greece and to evaluate their association with demographic, socio-economic and housing conditions. METHODS In a cross-sectional hospital-based study including 814 randomly selected children aged 6-36 months, BLLs and haematological parameters were evaluated. A questionnaire investigating demographic and socio-economic conditions was completed in all children. Statistical analysis was performed using STATA for Windows v.8.5, and P < 0.05 was considered statistically significant. RESULTS The mean BLLs of the population were 2.78 (SD = 2.34) µg/dl, and the median was 2.02 µg/dl; 11.7% had BLLs above 5 µg/dl, while 15 children (1.8%) exceeded 10 µg/dl. Being a toddler, being Roma or Asian, living in an industrial/low-income neighbourhood or in an old house, using traditional herbs and/or spices and having a mother with a manual occupation were independent risk factors for elevated BLLs. CONCLUSION Lead exposure remains a threat for optimal health especially for toddlers and children of socio-economically disadvantaged families living in Greece. A nationwide survey to assess lead exposure in children is necessary to guide prevention governmental policies.
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Affiliation(s)
- A Kapitsinou
- Second Department of Pediatrics, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Soldatou
- Second Department of Pediatrics, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Tsitsika
- Second Department of Pediatrics, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - L Kossiva
- Second Department of Pediatrics, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ch Tsentidis
- Second Department of Pediatrics, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - P Nisianakis
- Chemical Laboratory, Center of Biological Research of Armed Forces, Athens, Greece
| | - S Theocharis
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Garoufi
- Second Department of Pediatrics, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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