Evaluation of endothelial function and platelet activation in dyslipidemic children

Amaç: Bu çalışmada ailesel hiperlipidemi tanılı çocuklarda plazma homosistein, asimetrik dimetil arjinin, nitrotirozin ve p-selektin üzerinden endoteliyal fonksiyon ve trombosit aktivasyonunu plazma homosistein, asimetrik dimetil arjinin, nitrotirozin ve p-selektin aracılığı ile değerlendirmek amaçlandı. Yöntemler: 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 vazodilatasyon göstergeleri ekokardiyografi aracılığı ile değerlendirilmiştir. LDL-aferez işleminde absorpsiyon yöntemine dayalı çift membran tekniği kullanılmıştır. Plazma nitrotirozin, homosistein, asimetrik dimetil arjinin, ve p-selektin düzeyleri ELISA yöntemi ile bakılmıştır.Bulgular: Çalışmamızda, plazma homosistein düzeyi (p=0,000), ADMA (p=0.005), nitrotirozin (p=0.808), p-selektin (p=0.466) LDL-ferez olan uygulanan grupta en düşük bulunmuştur. Plazma homosistein ve "intima/media" kalınlığı arasında (r=0.334, p=0.043) pozitif korelasyon saptanmıştır. Çalışmamızda, LDL-ferez olan grupta plazma homosistein, ADMA ve nitrotirozin düzeyleri anlamlı düşük bulunmuş olup, endotaliyal disfonksiyon ve platelet aktivasyonun iyileştirilmesinde önemli bir role sahip olabileceği düşünülmüştür.Sonuç: Bu çalışmada, homozigot hiperlipidemi grubunun LDL-ferez sonrası homosistein, ADMA, ve nitrotirozin seviyeleri heterozigot hiperlipidemik çocuklara göre anlamlı oranda düşük saptanmıştır.

Dislipidemik çocuklarda endotelyal fonksiyon ve trombosit aktivasyonunun değerlendirilmesi

Objective: The aim of this study was to determine the parameters of endothelial function and platelet activation in children with familial hypercholesterolemia by measuring plasma homocysteine, asymmetrical dimethyl arginine (ADMA), nitrotyrosine and P-selectin levels. Methods: Thirty-five heterozygous familial hypercholesterolemic patients on statin therapy, 10 homozygous familial hypercholesterolemic patients treated by LDL apheresis and lipid-lowering drugs, and 25 healthy children, all aged between 2 to 16 years were enrolled in this study. Echocardiography was performed and intima-media thickness (IMT), and endotheliumdependent vasodilation parameters were evaluated. LDL apheresis was performed by adsorption method using double-membrane 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-selectin (p=0.466) levels were lowest in the LDL apheresis group. A positive correlation was detected between homocysteine and intima/media thickness (r=0.334, p=0.043). Showed that LDL apheresis therapy might decrease plasma levels of homocysteine, ADMA, and nitrotyrosine, and might eventually play an important role in the improvement of endothelial dysfunction and platelet activity.Conclusion: Our data showed that at post-LDL apheresis status the homozygous hyperlipidemic children have lower levels of homocysteine, ADMA, and nitrotyrosine, compared with the heterozygous hyperlipidemic children.

Kaynakça

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