Family history of cardiovascular disease and non-HDL cholesterol in prepubescent non-obese children

Strufaldi, Maria Wany Louzada; Souza, Fabíola Isabel Suano de; Puccini, Rosana Fiorini; Franco, Maria do Carmo Pinho

doi:10.1590/1806-9282.62.04.347

Brasil

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ORIGINAL ARTICLE • Rev. Assoc. Med. Bras. 62 (4) • July 2016 • https://doi.org/10.1590/1806-9282.62.04.347 linkcopy

Family history of cardiovascular disease and non-HDL cholesterol in prepubescent non-obese children

Importância clínica da história familiar de doença cardiovascular e da dosagem do colesterol não HDL em crianças eutróficas

Authorship SCIMAGO INSTITUTIONS RANKINGS

Summary

Objective: To describe the values of non-HDL cholesterol (NHDL-c) and the frequency of a family history of early cardiovascular disease (family HCVD) in healthy prepubescent children. Analyze the association between NHDL-c and family HCVD, and possible associations with other risk factors for cardiovascular disease (CVD).

Method: Cross-sectional study including 269 prepubescent (aged 6-10 years) schoolchildren with a normal body mass index (+1SD<BMI>-2SD). Data collected: Family HCVD; weight and height, waist circumference and systemic blood pressure; lipid profile (total cholesterol TC, HDL-c, triglycerides and LDL-c), NHDL-c calculation (CT-HDL-c, cut-off = 145 mg/dL) and insulin resistance (HOMA-IR).

Results: High levels were found for NHDL-c in 10 (3.7%) of these schoolchildren, and family early HCVD was found in 46 (17.1%) of them. There was a weak association between family HCVD and NHDL-c (Cramer’s-V-test = 0.120; p=0.050). Among the children with NHDL-c≥145 mg/dL, 4 (40%) have family HCVD. The presence of family HCVD was not associated with the variables being studied. The variables independently associated with NHDL-c ≥ 145 mg/dL were: HOMA-IR (OR=1.7; 95CI 1.1-2.6) and diastolic blood pressure (OR=1.1; 95CI 1.02-1.2).

Conclusion: NHDL-c values were associated with blood pressure and insulin resistance. Family HCVD was not associated with other classic risk factors for CVD, even though the frequency found was five times higher than that of high NHDL-c.

Keywords dyslipidemias; cardiovascular diseases; child; primary prevention

Variable		Total (n=269)
Birth weight	<2500g	35 (13%)
Family HCVD	Present	46 (17.1%)
Systolic BP	≥p90	3 (1.1%)
Diastolic BP	≥p90	12 (4.5%)
HOMA-IR	>2.0	50 (23.9%)
Blood glucose	≥100 mg/dL	4 (1.4%)
		Borderline	High
Triglycerides	75-99 and ≥100	65 (24.2%)	36 (13.3%)
TC	170-199 and ≥200	60 (22.3%)	5 (1.8%)
HDL-c	<40 and ≥45	71 (26.4%)	24 (8.9%)
LDL-c	100-129 and ≥130	35 (13.0%)	7 (2.6%)
NHDL-c	120-145 and ≥145	52 (19.3%)	10 (3.7%)

Variable		HCVD (+) (n=46)	HCVD (-) (n=223)	p-value
Age	years	8.6 (6.1;10.9)	8.3 (6.0;10.9)	0.225^* * Level of significance in Mann-Whitney test.
Birth weight	grams	3020 (1250;4400)	3180 (875;4830)	0.243^* * Level of significance in Mann-Whitney test.
BMI	z-score	0.06 (-1.7;0.9)	-0.23 (-1.9;0.9)	0.248^* * Level of significance in Mann-Whitney test.
Waist/height	cm	0.42 (0.4;0.5)	0.42 (0.2;0.5)	0.569^* * Level of significance in Mann-Whitney test.
Systolic BP	mmHg	90.0 (80.0;110.0)	90.0 (70.0;120.0)	0.213^* * Level of significance in Mann-Whitney test.
Diastolic BP	mmHg	60.0 (40.0;80.0)	60.0 (40.0;80.0)	0.173^* * Level of significance in Mann-Whitney test.
HOMA-IR		1.2 (0.3;6.7)	1.0 (0.1;7.0)	0.356^* * Level of significance in Mann-Whitney test.
Blood glucose	mg/dL	81.0 (69.0;103.0)	80.0 (46.0;107.0)	0.064^* * Level of significance in Mann-Whitney test.
Insulin	uU/mL	6.3 (1.4;31.0)	5.6 (1.0;31.8)	0.446^* * Level of significance in Mann-Whitney test.
NHDL-c	mg/dL	109.5 (61.0;187.0)	101.0 (47.0;161.0)	0.060^* * Level of significance in Mann-Whitney test.
Gender	male	24	128	0.519^† † Level of significance in Chi-squared test.

Variable		NHDL-c ≥145 mg/dL	NHDL-c <145 mg/dL	p-value
		(n=10)	(n=259)
Age	years	9.3 (6.0;10.0)	8.3 (5.0;10.0)	0.185^* * Level of significance in Mann-Whitney test.
Birth weight	grams	2820 (2080;3878)	3180 (875;4830)	0.300^* * Level of significance in Mann-Whitney test.
BMI	z-score	0.20 (-1.5;0.8)	-0.15 (-1.9;0.9)	0.647^* * Level of significance in Mann-Whitney test.
Waist/height	cm	0.43 (0.4;0.5)	0.42 (0.2;0.5)	0.213^* * Level of significance in Mann-Whitney test.
Systolic BP	mmHg	92.5 (80.0;100.0)	90.0 (70.0;120.0)	0.063^* * Level of significance in Mann-Whitney test.
Diastolic BP	mmHg	65.0 (50.0;80.0)	60.0 (40.0;80.0)	0.008^* * Level of significance in Mann-Whitney test.
HOMA-IR		2.2 (1.3;7.0)	1.05 (0.1;6.6)	<0.001^* * Level of significance in Mann-Whitney test.
Blood glucose	mg/dL	85.5 (70.0;95.0)	80.0 (46.0;107.0)	0.103^* * Level of significance in Mann-Whitney test.
Insulin	IU/mL	9.9 (6.6;31.8)	5.5 (1.0;31.0)	<0.001^* * Level of significance in Mann-Whitney test.
Gender	male	6 (60%)	146 (56.3%)	0.544^† † Level of significance in Chi-squared test.
Cardiovascular risk	present	4 (40%)	42 (16.2%)	0.073^† † Level of significance in Chi-squared test.

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[1] HCVD: history for cardiovascular disease; BP: blood pressure; HOMA-IR: homeostatic model assessment - insulin resistance; TC: total cholesterol; HDL-c: high-density lipoprotein cholesterol; LDL-c: low-density lipoprotein cholesterol; NHDL-c: non-HDL cholesterol.