The dissertation focuses on examining the impact of dyslipidemia on children's
cardiovascular system, enhancing early detection diagnostics for potential
cardiovascular lesions, devising preventive measures for timely identification, and
developing therapeutic strategies for children with dyslipidemia, including genetically
determined cases.
Identifying high-risk groups for premature cardiovascular lesions, searching for
effective markers of preclinical cardiovascular damage in children from atherosclerotic
risk groups, and promoting normal physical development and cardiovascular health in
childhood highlight the significance of this study, justifying further investigation of
potential disorders and subsequent correction methodologies. To attain the study's
objective, the subsequent goals were established:
1. To analyze the qualitative and quantitative changes in the nutritional
profile and dietary compliance in children with dyslipidemia, including familial
hypercholesterolemia.
2. To examine the quality of life and energy expenditure for physical activity
in children with dyslipidemia, including familial hypercholesterolemia.
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3. To examine the composition of blood serum lipids, the concentrations of
apolipoprotein A1 and B, and the dp-uc MGP protein marker for microcalcification
prediction in patients with familial hypercholesterolemia, applying a systematic
methodology.
4. To conduct physical examination and cardiac diagnostic studies in children
with dyslipidemia, including familial hypercholesterolemia. The research will evaluate
changes in the intima-media complex thickness of the common carotid artery, assess
the arterial stiffness through the ankle-brachial index, and determine the morphological
and functional echocardiographic characteristics.
5. To perform a comprehensive assessment of the relationship between the
nutritional profile indicators, the health-related quality of life scores, the energy
expenditure for physical activity level, the extended lipid profile data, the dp-uc MGP
protein concentration level, and the cardiac diagnostic studies data to create a statistical
model with predictors of cardiovascular disease.
6. To develop a program to diagnose and prevent a cardiovascular disease in
children with dyslipidemia, including familial hypercholesterolemia.
To achieve the study's objectives, we monitored 118 children with dyslipidemia,
including those with familial hypercholesterolemia (n = 15), in the cardio-rheumatology
department of Kyiv City Children’s Clinical Hospital No.1. 21 healthy peers were
included as a comparison group. The children, aged 5 to 18 and of both sexes, were
categorized by age according to WHO recommendations.
The scientific data pertaining to the physical development of children with
dyslipidemia, including familial hypercholesterolemia, has been significantly enriched.
Based on an auxological analysis, patients with dyslipidemia exhibited a statistically
significant higher body weight and BMI than their healthy peers. Retrospective data
analysis further revealed an average age of dyslipidemia onset as 12.0 ± 3.63 years
amongst the study's subjects. The mean age at which familial hypercholesterolemia was
diagnosed among the study participants was 11.6 ± 4.06 years, a noteworthy observation
considering that the prevailing guidance in current literature suggests initiation of
treatment within the age range of 8 to 10 years. Based on the listed findings, it is advised
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that an initial lipid profile including total cholesterol (TC), HDL-C, LDL-C, VLDL-C,
remnant cholesterol, triglycerides (TG), and non-HDL-C levels should be conducted for
all children aged 7 years and those at risk beginning at 2 years of age.
Assessing anthropometric indicators across different age groups in children with
FH revealed that a majority (60-80%) exhibit harmonious physical development.
Nevertheless, obesity is observed in every fifth child within the age groups of 5-9 years
and 15-18 years. Conversely, in the age group of 10-14 years, every fifth child is
identified as underweight.
Particular attention was given to analyzing the nutritional profile of a comparison
group comprising healthy children. The goal was to identify any potential differences
between their nutritional profiles and those of children with dyslipidemia and,
consequently, to gain a better understanding of the impact of nutrition on children's
health, particularly as it relates to physical development and cardiovascular health.
