[Lipid profile in newborns with intrauterine growth retardation]

BACKGROUND

The X syndrome, related to coronary disease in adults, could be possibly programmed priory to delivery, in children with intrauterine growth retardation.

AIM

To measure serum lipids in newborns with symmetrical or asymmetrical intrauterine growth retardation.

PATIENTS AND METHODS

One hundred thirty-five newborns with intrauterine growth retardation and 116 normal term newborns, with 38 to 41 gestational weeks, were studied. Total, HDL, and LDL cholesterol, triglycerides and apoproteins. A1 and B were measured in umbilical cord blood samples.

RESULTS

No differences in total, HDL, LDL cholesterol, apoproteins A1 and B were observed between the study groups. Triglycerides were higher in newborns with intrauterine growth retardation, compared to normal term newborns (45 +/- 27 and 36 +/- 19 mg/dl respectively, p < 0.001). Differences in serum triglyceride levels respect to controls were observed in both male and female newborns with asymmetrical growth retardation. Likewise the differences respect to controls were observed in newborns with mild or severe but not with moderate growth retardation.

CONCLUSIONS

Newborns with intrauterine growth retardation have higher triglyceride levels than normal term newborns.

[Lipids, lipoproteins and apolipoproteins in normal newborns]

BACKGROUND

In Chile, there is a high prevalence of cardiovascular diseases. Because atherosclerosis starts in childhood, it is important to assess serum lipid levels in children.

AIM

To measure serum lipid levels in normal Chilean newborns.

SUBJECTS AND METHODS

A sample of umbilical cord venous blood was obtained from 156 normal newborns (76 male) immediately after delivery. Total and HDL cholesterol, triglycerides, apoprotein A1, B and lipoprotein (a) were measured.

RESULTS

Mean values for total cholesterol in males, females and in the total sample were 60.6, 67.8 and 64 mg/dl respectively. The figures for HDL cholesterol were 24.9, 29.3 and 27 mg/dl, for LDL cholesterol were 28.3, 32.4 and 30 mg/dl, for triglycerides were 37.5, 30.3 and 35 mg/dl, for apoprotein A1 were 69, 79 and 74 mg/dl, for apoB were 23, 25 and 24 mg/dl and for lipoprotein (a) were 1.58, 1.79 and 1.69 mg/dl. Total cholesterol, HDL cholesterol, triglycerides and apoprotein A1 were significantly different between sexes. Percentiles 5 and 95 for total cholesterol were 37 and 111, for HDL cholesterol were 14 and 40, for LDL cholesterol were 13 and 57, for triglycerides were 20 and 69, for apoprotein A1 were 53 and 101, for apoprotein B were 11 and 48 and for lipoprotein (a) were 1.3 and 2.1 mg/dl. Five percent of children had apoprotein B values over 48 mg/dl.

CONCLUSIONS

The detection of high levels of apoprotein B in newborns, could allow the early identification of individuals with high cardiovascular risk.

[Serum lipid levels in children and teenagers from Concepción, Chile]

BACKGROUND

There is a relationship between serum lipid levels in children with those of adults. Preventive measures to reduce serum lipid levels should start in childhood.

AIM

To study serum lipid levels in a representative sample of children and teenagers from Concepción, Chile.

SUBJECTS AND METHODS

Serum total, HDL cholesterol and triglycerides were measured in 1,286 males and 816 females from 5 to 18 years old in the city of Concepción.

RESULTS

Mean total cholesterol levels were 159 +/- 30 and 162 +/- 31 mg/dl in males and females respectively. The figures for HDL cholesterol were 46 +/- 11 and 47 +/- 11 mg/dl, for LDL cholesterol were 94 +/- 27 and 96 +/- 29 mg/dl and for triglycerides were 80 +/- 35 and 87 +/- 38 mg/dl. Nine percent of males and 12% of females had a total cholesterol over 200 mg/dl. Likewise 10% of males and 11% of females had a LDL cholesterol over 130 mg/dl.

CONCLUSIONS

These numbers will help to plan and perform interventions in children, in order to prevent cardiovascular diseases.

[Lipoprotein in children and adolescents: relationship with family history of coronary artery disease]

BACKGROUND

Lipoprotein (a) is considered an independent cardiovascular risk factor.

AIM

To study lipoprotein (a) levels in children of 18 years old or less with or without family history of coronary artery disease.

SUBJECTS AND METHODS

Forty four children aged between 3 and 18 years old with a family history of coronary artery disease and 44 age and sex matched controls were studied. A fasting blood sample was obtained to measure total, HDL and LDL cholesterol, triglycerides, A1 and B apoproteins and lipoprotein (a).

RESULTS

Compared to controls, children with a family history of coronary disease had higher total cholesterol (177 +/- 35 and 159 +/- 23 mg/dl respectively), LDL cholesterol (112 +/- 34 and 94 +/- 21 mg/dl respectively), triglycerides (89 +/- 38 and 71 +/- 25 mg/dl respectively), apoprotein B (85 +/- 17 and 65 +/- 13 mg/dl respectively) and lipoprotein (a) (40 +/- 50 and 22 +/- 31 mg/dl respectively). Thirty two percent of children with positive family history had lipoprotein (a) levels over 30 mg/dl, compared to 23% of controls.

CONCLUSIONS

Children with family history of coronary artery disease have higher levels of cholesterol, triglycerides and lipoprotein (a) than matched controls.

[Influence of ethnic and environmental factors the lipid profile in school children from the VIII Region]

We studied fasting total, HDL cholesterol and triglycerides in 329 children aged from 6 to 15 years. One hundred and ten lived in Concepción and were considered urban. Two hundred nineteen lived in Alto Bio-Bio and were considered rural; of these, 173 had a pehuenche aboriginal origin. Rural pehuenche, rural non pehuenche and urban children had a total cholesterol of 123.7 +/- 23, 133.7 +/- 25.8 and 153.7 +/- 29.7 mg/dl respectively, a HDL cholesterol of 39.2 +/- 9.1, 38.8 +/- 9.1 and 46.2 +/- 11.3 mg/dl respectively and triglycerides of 83.3 +/- 33.5, 96.7 +/- 33.5 and 81.9 +/- 33.3 mg/dl respectively. Lipid levels were above safe values in 2.9% of pehuenche, 8.7% non pehuenche rural and 13.6% or urban children. It is concluded that the higher lipid levels of urban and non pehuenche children supports the favorable effect of rural environment and pehuenche ethnic origin on cardiovascular risk factors.

Serum adenosine deaminase in the early diagnosis of typhoid fever

To study the usefulness of the enzyme adenosine deaminase for the early diagnosis of typhoid fever, its activity in serum was assayed in 277 children admitted to the Hospital Guillermo Grant Benavente at Concepción, Chile, from March, 1988, to December, 1990. The children were distributed into seven groups: control, N = 82; bacteremia, N = 8; acute viral respiratory infection, N = 43; febrile children with miscellaneous etiologies, N = 49; pulmonary tuberculosis, N = 3; hepatitis A virus infection, N = 30; and typhoid fever, N = 62. The medium serum adenosine deaminase values were significantly higher in children with typhoid fever (P < 0.0001) in relation to the values in the control group (122.2 +/- 40.7 vs 28.1 +/- 8.4 units/liter at 37 degrees C). This test had a sensitivity of 91.9% and a specificity of 92.5% in identifying the patient with typhoid fever when using 80 units/liter as the cutoff values. The positive predictive value of the test was 83.8% and the negative predictive value was 96%. Determination of adenosine deaminase values in serum could be helpful in the early diagnosis of typhoid fever.

[Adenosine deaminase in typhoid fever and other febrile diseases]

The contribution of serum adenosine deaminase (ADA) activity to the diagnosis of typhoid fever was assessed in 246 children and in 46 adults, by Giusti's original technique. Children included otherwise healthy patients admitted for elective surgical conditions or under follow up for epilepsy which were considered to be a control group (n: 81), presumptive viral diseases (n: 31), miscellaneous febrile diseases except for typhoid fever (n: 41), different kinds of bacteremia (n: 6), diarrhea due to Salmonella typhimurium (n: 14), viral hepatitis (n: 24), and culture proven typhoid fever (n: 49). Adult's group included 39 healthy controls and 7 patients with culture proven typhoid fever. Among children mean ADA activity was as follows: control group 28 +/- 7.8, viral disease 35.3 +/- 13.1, miscellaneous febrile disease 36.1 +/- 15.6, bacteremia group: 30.3 +/- 10.3, salmonellosis group 51.6 +/- 9, hepatitis group 68.3 +/- 34.5, typhoid fever group 124.4 +/- 40.8 U/I 37 degrees C. Among adults, values were 18.4 +/- 7.5 for controls and 112.8 +/- 19.2 U/I 37 degrees C in typhoid fever patients. In both adults and children ADA activity was significantly higher in the typhoid fever group (p < 0.0001). Untreated typhoid fever patients had their higher ADA activity between 10th and 15th day of illness. When ADA cut point was set at 80 U/I, sensitivity of the test was 91.8% and specificity was 91.4% as a preliminary clue to the recognition of typhoid fever.

[Risk factors of cardiovascular disease in a Chilean school population: I: Blood lipids in 552 children and adolescents 6-15 years of age]

The distribution of serum cholesterol (TC), low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL)-cholesterol and triglycerides (TG), and the prevalence of risk-considered values were studied in school children from Concepción, Chile (6 to 15 years old; 326 boys, 226 girls). The mean TC levels were 146 mg/dl for boys and 154 mg/dl for girls but 9.1% of the sampled children had TC values between 175 and 190 mg/dl, and 10% were over 190 mg/dl. Mean LDL-C was 83 mg/dl in boys and 89 mg/dl in girls; 6% of samples showed values between 130 and 159 mg/dl, and 1.3% over 160 mg/dl. Mean HDL-C was 46 mg/dl for boys and 48 mg/dl for girls. The mean TG values were 80 mg/dl for boys and 93 mg/dl for girls.