Abstract
Familial hypercholesterolemia (FH), the most common disorder of inborn errors of metabolism, and non familial hypercholesterolemia, are characterized by significant elevation of Total-Cholesterol (TC) and Low-density-lipoproteins (LDL). Based on the results of studies in adults, it is anticipated that even in children diet and, if necessary, drugs might be able to prevent later CHD. In this regard, only few long-term follow-up studies exist: Glueck (1977) et al. reported in a 7 years follow-up normal growth, whereas Lifshitz 1989 reported adverse effects of strict dietary regimen on the growth in some patients.
The aim of our study was to examine the efficacy and safety of long-term cholesterol-lowering diet (mean 4.5±2.1 years) in 14 children (9 boys, 5 girls) with hypercholesterolemia. From the total group 9 had FH, 5 polygenic hypercholesterolemia. Diet composition was: fat 30 % and cholesterol less than 250 mg per day (saturated fat intake was less than 10 % of total energy). 12 patients were treated with diet alone, 2 had diet plus bile acid-binding resins (Cholestyramine 20 g/d). Additionally, we prospectively followed the children in regards to their development of height and weight during the whole period of treatment. All children grew on continuous percentiles and also had a normal weight percentile. Over the time, a significant reduction of TC (-25.8 %), LDL-C (-29.4 %) and ApoB (-33.6 %) respectively, was found. Only 1 child who did not follow the diet had a falloff in linear growth from 25 to 15 percentile and a reduction of weight from 75 to 45 percentile.
From these results, we conclude that careful monitoring of children receiving a low-fat/low-cholesterol diet ensure adequate nutrition for normal growth and development and also is associated with significant reduction of TC and LDL-C.
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Widhalm, K., Da Cruz, B., Leitner, G. et al. 38 ANTHROPOMETRIC ASSESSMENT OF CHILDREN WITH HYPERCHOLESTEROLEMIA IN A LONG-TERM STUDY. Pediatr Res 28, 283 (1990). https://doi.org/10.1203/00006450-199009000-00062
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DOI: https://doi.org/10.1203/00006450-199009000-00062