Abstract

INTRODUCTION

The aim of this study was to determine the parameters in relation with endothelial function and platelet activation in children with familial hypercholesterolemia by measuring plasma homocysteine, assymetrical dimethyl arginin (ADMA), nitrotyrosine and p-selectin.

METHODS

Thirty five heterozygous familial hypercholesterolemic patients on statin therapy, 10 homozygous familial hypercholesterolemic patients treating by LDL apheresis and lipid-lowering drugs, and 25 healthy children, all aged between 2 to 16, were enrolled in this study. Echocardiography was performed and intima-media thickness (IMT), endothelium-dependent vasodilation parameters were evaluated. LDL apheresis was performed by adsorbtion method by using double membran filtration technique. Plasma nitrotyrosine, homocysteine, p-selectin and ADMA levels were determined with an enzyme-linked immunosorbent assay (ELISA) using a commercial kit.

RESULTS

Plasma homocysteine (p= 0.000), ADMA (p= 0.005), nitrotyrosine (p=0.808), p-selectine (p= 0.466) were lowest in the LDL apheresis group. Positive correlation was detected between homocysteine and intima/media thickness (r=0.334, p=0.043). Our data showed that LDL apheresis therapy might decrease plasma levels of homocysteine, ADMA, and nitrotyrosine, and eventually plays an important role in the improvement of endothelial dysfunction and platelet activity.

DISCUSSION AND CONCLUSION

Our data showed that at post-LDL apheresis status the homozygous hyperlipidemic children have lower levels of homocysteine, ADMA, and nitrotyrosine, compare to the heterozygous hyperlipidemic children