Search

Introduction. Familial hypercholesterolemia is a congenital disorder of lipid metabolism. The Dutch Lipid Clinic Network score is used for early diagnosis of familial hypercholesterolemia. The aim of the study was to examine correlation between the above score and the first measured lipid values in patients who had not used lipid-lowering therapy. Material and Methods. 390 patients identified as familial hypercholesterolemia+ (n=247) and familial hypercholesterolemia- (n=143) according to the Dutch Lipid Clinic Network score. Family and personal history, physical examination, demographic and anthropometric characteristics and lipid status were analyzed. Results. The familial hypercholesterolemia+ group had all Dutch Lipid Clinic Network score components significantly higher than the familial hypercholesterolemia- group. The highest average number of points in familial hypercholesterolemia+ group carries low-density lipoprotein level and family history data. Significantly higher levels of total cholesterol, low-density lipoprotein and apolipoprotein B were found in the familial hypercholesterolemia+ group, while high-density lipoprotein was lower in the familial hypercholesterolemia- group. The Dutch Lipid Clinic Network score correlates best with level of lowdensity lipoprotein and apolipoprotein B (p<0.001). The cut-off point for low-density lipoprotein is 4.9 mmol/L (sensitivity 56%; specificity 8%), while the cut-off point for apolipoprotein B is 1.52 g/L (sensitivity 42%; specificity 12.5%) for diagnosis of familial hypercholesterolemia. Conclusion. Low-density lipoprotein and apolipoprotein B values significantly correlate with Dutch Lipid Clinic Network score values. Elevated values of low-density lipoprotein (>4.9 mmol/L) significantly affect the total value of the Dutch Lipid Clinic Network score and are considered components that carry large number of points for the diagnosis of familial hypercholesterolemia. [ABSTRACT FROM AUTHOR]

Introduction. Familial hipercholesterolemia is monogenetic disorder associated with early onset of cardiovascular disease. The measurement of low density cholesterol is the primary therapeutic goal in familial hypercholesterolemia patients, but despite the lipid-lowering therapy cardiovascular disease still occurs. It became clear that it's necessary to consider residual cardiovascular risk. The aim of study was to evaluate residual cardiovascular risk in familial hipercholesterolemia. Material and Methods. In this cross-sectional study we included 291 familial hipercholesterolemia patients with and without previously diagnosed diabetes. Based on value of the Dutch Lipid Clinical Network score criteria, familial hipercholesterolemia patients without diabetes was further divided into: possible (3-5 points), probable (6-8 points), and definite (>8 points) familial hypercholesterolemia. Triglyceride to high density cholesterol ratio, non-HDL-cholesterol and remnant cholesterol were used as parameters of lipid residual cardiovascular risk. Results. We found statistically significant differences in total cholesterol, low and high density cholesterol, triglycerides and apolipoprotein B between the groups (p>0.05). The definite and probable group had higher non-HDL-cholesterol values than possible and familial hypercholesterolemia with diabetes (p<0.01) groups. Familial hypercholesterolemia with diabetes group had higher values of triglyceride to high density cholesterol ratio and remnant cholesterol than definite and probable group (p<0.01). Regression analysis showed that triglyceride to high density cholesterol ratio was independent predictor of appearance of coronary artery disease in addition to elevated low density cholesterol and non-HDL-cholesterol (p<0.01). Conclusion. Triglyceride to high density cholesterol ratio is the most important parameter of the lipid residual cardiovacular risk that strongly linked with cardiovascular disease in familal hypercholesterolemia patients, especially with associated diabetes. [ABSTRACT FROM AUTHOR]