The Role of Asymmetric Dimethylarginine and Lipoprotein Associated Phospholipase A2 in Children and Adolescents with Dyslipidemia

摘要

Background: The pathophysiologic mechanisms which lead to cardiovascular (CV) events begin early in childhood. Atherosclerosis is recognized as a process of chronic and dynamic vascular inflammation induced primarily by endothelial dysfunction. Asymmetric dimethylarginine (ADMA) and lipoprotein associated phospholipase A2 (Lp-PLA2) are considered markers of early atherosclerosis and predictors of late complications in adults. Objectives: To establish the relationship between ADMA, Lp-PLA2 and traditional biochemically determined markers in children and adolescents with dyslipidemia. Material and Methods: The study population consisted of 102 children, 57 males/45 females, with a median age of 9.9 years. Seventy-one out of 102 had dyslipidemia (LDL-C levels ≥ 130 mg/dl). Lipid levels were estimated after an overnight fasting. LDL-C concentration was directly measured. ADMA and Lp-PLA2 levels were assessed by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using STATA for Windows v8.5. Results: ADMA was significantly positively correlated with all TC, LDL-C and non-HDL-C. Even small changes of the ADMA concentration were found to be followed by corresponding alterations in lipid levels. A positive correlation of borderline significance between Lp-PLA2 and LDL-C or non- HDL-C was observed. In addition, ADMA and Lp-PLA2 were significantly correlated. A strong correlation between Lp-PLA2 and dyslipidemia or lipid levels could not be established, probably due to the size and heterogeneity of our sample. Conclusions: A relationship of ADMA and Lp-PLA2 levels with biochemical markers associated with long-term risk of atherosclerosis in children and adolescents is supported. The assessment of these two biomarkers combined may improve CV risk prediction and future management strategies in the pediatric population.