Key result
In children with familial combined hyperlipidemia, percentage of ideal body weight and age were significantly correlated with plasma triglyceride levels (r=0.45, P=0.006 and r=0.48, P=0.003).
Cross-Sectional (n=225)
Triglyceride levels in children with familial combined hyperlipidemia are sensitive to obesity and age, suggesting a gradual expression of hyperlipidemia influenced by weight.
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May inform weight-focused interventions in pediatric FCH; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Familial combined hyperlipidemia (FCHL) has been described as the leading cause of familial hyperlipidemia. FCHL is dominantly inherited, occurs in at least 1% of the population, and is responsible for about 10% of premature coronary artery disease (CAD). OBJECTIVE: Because FCHL in childhood is not well characterized, we evaluated the interrelationships among age, percentage of ideal body weight (%IBW) and plasma lipoprotein levels in FCHL children (age 2-18 years), exploring the possibility that obesity and age may influence the presentation of FCHL in childhood. METHODS: One hundred and eighty-nine children with FCHL were studied. Significant correlations within this group were further evaluated by examining a subset of 36 FCHL children, each of whom had an unaffected sibling who could serve as a control for comparison. RESULTS: When the full group was divided into those with TG levels > 90% and those with TG levels < 90%, the correlation with %IBW was stronger in the former (r = 0.45, P < 0.005) as compared with the latter (r = 0.25, P = 0.05). Within the subset of 36 FCHL children and their 36 unaffected siblings (controls), age and sex distributions were similar. Percentage IBW (mean +/- S.D.) (117.3 +/- 29.1 for FCHL and 111.2 +/- 19.4 for controls) was similar and in the overweight range. FCHL children had significantly higher levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), apolipoprotein B (apo B) and triglyceride (TG) levels compared with controls (P < 0.0005 for all comparisons). Of several significant correlations observed in the full group (n = 189), only the correlations of %IBW with plasma TG levels (r = 0.45, P = 0.006), and of age with plasma TG levels (r = 0.48, P = 0.003) persisted with a similar degree of magnitude in the subset of 36 FCHL children. No correlation was significant in the controls. By Fisher's Z-test, the correlation between %IBW and TG in the FCHL children was significantly different from controls. CONCLUSIONS: These results suggest that TG levels in FCHL children, but not in their unaffected siblings, and sensitive to the presence of obesity, implying an interaction between obesity and the underlying condition, in addition, the association between age and TG level in FCHL children suggests a gradual expression of the hyperlipidermia (i.e. TG) during childhood.
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Shamir et al. (1996) conducted a cross-sectional in Familial combined hyperlipidemia (FCHL) (n=225). Age and percentage of ideal body weight (%IBW) vs. Unaffected siblings was evaluated on Correlation of percentage of ideal body weight (%IBW) and age with plasma triglyceride (TG) levels (r = 0.45 for %IBW; r = 0.48 for age, p=0.006 and 0.003). In children with familial combined hyperlipidemia, percentage of ideal body weight and age were significantly correlated with plasma triglyceride levels (r=0.45, P=0.006 and r=0.48, P=0.003).
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