High lipoprotein(a) concentrations are associated with impaired endothelial function in children.

Jouni Lapinleimu, Olli T Raitakari, Helena Lapinleimu, Katja Pahkala, Tapani Rönnemaa, Olli G Simell, Jorma S A Viikari

Journal: The Journal of pediatrics 2015;166(4):947-52.e1-2

PMID: 25661407

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVE

To examine the association between familial high lipoprotein(a), or Lp(a), concentrations and endothelial function in children participating in the Special Turku Coronary Risk Factor Intervention Project study.

STUDY DESIGN

Seven-month-old children (n = 1062) with their families were randomized to a risk intervention group or to a control group. The intervention group received individualized dietary counseling to reduce the total cholesterol concentration. Children's Lp(a) and lipid values were measured repeatedly. At age 11 years, children were recruited to an ultrasound study of the flow-mediated dilation (FMD) of the brachial artery. The association between relative peak FMD and Lp(a) concentration was examined in 198 control and 193 intervention group children by linear regression analyses adjusted for sex, total cholesterol concentration, and basal artery diameter. The analyses were made in both the control and intervention groups and in the familial risk children who had a parent with Lp(a) concentration greater than 250 mg/l.

RESULTS

Lp(a) concentrations were similar at age 11 years in the intervention and control groups. In all control children, FMD (%) associated inversely with Lp(a) concentration: (β [%/1000 mg/L] = -3.74, 95% CI [-6.43, -1.45]; P = .007) and in 68 familial risk children (β = -4.92, 95% CI [-8.18, -1.66]; P = .0037). In the intervention group the associations were lacking (P > .5), and FMD in the children with high Lp(a) concentrations (>500 mg/L, n = 12) had no attenuation (P = .027).

CONCLUSIONS

Familial high Lp(a) concentration is associated with attenuated endothelial function. This association may be mitigated by an early lifestyle intervention.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT00223600.

Address: Department of Medicine, University of Turku, Turku, Finland; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Division of Medicine, TYKS Salo Hospital, Salo, Finland.; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland.; Department of Pediatrics, University of Turku, Turku, Finland; Department of Pediatrics, Turku University Hospital, Turku, Finland.; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Sports & Exercise Medicine Unit, Department of Health and Physical Activity, Paavo Nurmi Centre, Turku, Finland.; Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland.; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Pediatrics, University of Turku, Turku, Finland.

DOI: 10.1016/j.jpeds.2014.12.051

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MeSH Terms: Biomarkers, Blood Pressure, Child, Child, Preschool, Endothelium, Vascular, Female, Humans, Hyperlipoproteinemia Type II, Immunoradiometric Assay, Infant, Infant, Newborn, Lipoprotein(a), Male, Prognosis, Risk Factors, Vasodilation