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Evaluation of endothelial function and platelet activation in dyslipidemic children [J Behcet Uz Child Hosp]
J Behcet Uz Child Hosp. 2016; 6(1): 53-58 | DOI: 10.5222/buchd.2016.053  

Evaluation of endothelial function and platelet activation in dyslipidemic children

Sema Kalkan Uçar1, Yasemin Delen Akcay2, Turan Kologlu2, Ertürk Levent1, Eser Yıldırım Sozmen2, Mahmut Çoker1
1Department Of Pediatrics, Ege University Medical Faculty, Izmir, Turkey
2Department Of Medical Biochemistry, Ege University Medical Faculty, Izmir, Turkey

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

Keywords: Children, Homozygous/ heterozygous familial hypercholesterolemia, Homocysteine, Asymmetrical Dimethyl Arginin (ADMA), Nitrotyrosine


Dislipidemik çocuklarda endotelyal fonksiyon ve trombosit aktivasyonunun değerlendirilmesi

Sema Kalkan Uçar1, Yasemin Delen Akcay2, Turan Kologlu2, Ertürk Levent1, Eser Yıldırım Sozmen2, Mahmut Çoker1
1Ege Üniversitesi Tıp Fakültesi, Çocuk Sağlığı Ve Hastalıkları Ana Bilim Dalı, İzmir
2Ege Üniversitesi Tıp Fakültesi, Tıbbi Biyokimya Ana Bilim Dalı, İzmir

GİRİŞ ve AMAÇ: Bu çalışmada ailesel hiperlipidemi tanılı çocuklarda endoteliyal fonkisyon ve trombosit aktivasyonunu, plazma homosistein, asimetrik dimetil arjinin, nitrotirozin ve p-selektin aracılığı ile değerlendirilmesi amaçlanmıştır.
YÖNTEM ve GEREÇLER: Çalışmaya 2-16 yaş arası, statin kullanan 35 ailesel heterozigot hiperlipidemik hasta; LDL-ferez uygulanan 10 homozigot hiperlipidemik hasta ve 25 sağlıklı çocuk katılmıştır. “İntima-media” kalınlığı, endotelium bağımlı vasodilatasyon göstergeleri ekokardiyografi aracılğı ile değerlendirilmiştir. LDL- aferez işlemi adsorbsiyon yöntemine dayalı çift membran tekniği ile uygulanmıştır. Plazma nitrotirozin, homosistein, asimetrik dimetil arjinin, ve p-selektin düzeyleri ELISA yöntemi ile bakılmıştır.
BULGULAR: Plazma homosistein (p=0.000), ADMA (p=0.005), nitrotirozin (p=0.808), p-selektin (p=0.466) LDL-ferez olan grupta en düşük bulunmuştur. Plazma homosistein ve “intima/media” kalınlığı arasında (r=0.334, p=0.043) pozitif koralasyon saptanmışıdır. Bizim çalışmamızda LDL-ferez olan grupta plazma homosistein, ADMA, ve nitrotirozin anlamlı düşük bulunmuş olup endotaliyal disfonksiyon ve platelet aktivasyonun iyileştirilmesinde önemli bir role sahip olabileceği düşünülmüştür.
TARTIŞMA ve SONUÇ: Bu çalışmada homozigot hiperlipidemi grubunun LDL-ferez sonrası homosistein, ADMA, ve nitrotirozin seviyeleri heterozigot hiperlipidemk çocuklara göre anlamlı düşük saptanmıştır.

Anahtar Kelimeler: Çocuklar, ailesel homozigot/heterozigot hiperlipidemi, Homosistein, Asimetrik Dimetil Arjinin (ADMA), Nitrotirozin


Sema Kalkan Uçar, Yasemin Delen Akcay, Turan Kologlu, Ertürk Levent, Eser Yıldırım Sozmen, Mahmut Çoker. Evaluation of endothelial function and platelet activation in dyslipidemic children. J Behcet Uz Child Hosp. 2016; 6(1): 53-58

Corresponding Author: Sema Kalkan Uçar, Türkiye


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