[Lipid profile and nutrition counseling effects in adolescents with family history of premature coronary artery disease]. / Perfil lipídico e efeitos da orientação nutricional em adolescentes com história familiar de doença arterial coronariana prematura.

OBJECTIVE: To assess lipid profile and nutritional parameters from adolescents with family history of premature coronary artery disease (CAD) and assess the effects of nutritional counseling. METHODS: The study included 48 adolescents of both gender and with ages ranging from 10 and 19 years old (case group, n=18; control group, n=30). RESULTS: Offspring of young individuals with coronary artery disease showed higher values of total cholesterol (189 +/- 30 vs. 167 +/- 26 mg/dl, p < 0.01), LDL-C (144 +/- 20 vs. 100 +/- 27 mg/dl, p < 0.001) and apoB (80 +/- 15 vs. 61 +/- 18 mg/dl, p = 0.001) and lower values of HDL-C (45 +/- 9 vs. 51 +/- 13 mg/dl, p < 0.02) than control young individuals. Differences were not found for triglycerides and apoA-I. With a dietotherapeutic counseling, we obtained a reduction in alimentary consumption of saturated fatty acids (pre: 15.5 +/- 4.7% vs. post: 6.6 +/- 3.7%, p = 0.003) and an improvement in lipid profile: TC (-8%, p = 0.033), LDL-C (-18.2%, p = 0.001), TG (-53%, p = 0.002) rates in offspring of premature CAD patients who showed hyperlipidemia. CONCLUSION: The presence of dyslipidemia was more prevalent among offspring adolescents of premature CAD patients, but it was responsive to nutritional intervention.

Perfil lipídico e efeitos da orientação nutricional em adolescentes com história familiar de doença arterial coronariana prematura / Lipid profile and nutrition counseling effects in adolescents with family history of premature coronary artery disease

OBJETIVO: Examinar o perfil lipídico e parâmetros nutricionais de adolescentes com história familiar de doença arterial coronariana (DAC) prematura e avaliar os efeitos da orientação nutricional. MÉTODOS: O estudo incluiu 48 adolescentes de ambos os sexos e idades entre 10 e 19 anos (grupo caso, n=18; grupo controle, n=30). RESULTADOS: Os filhos de coronarianos jovens apresentaram valores mais elevados de colesterol total (189 ± 30 vs. 167 ± 26 mg/dl, p<0,01), LDL-C (144 ± 20 vs. 100 ± 27 mg/dl, p<0,001) e Apo B (80 ± 15 vs. 61 ± 18 mg/dl, p=0,001) e valores mais baixos de HDL-C (45 ± 9 vs. 51 ± 13 mg/dl, p<0,02) que os jovens controles. Não se observaram diferenças para os triglicérides e Apo A-I. Com a orientação dietoterápica obteve-se redução no consumo alimentar de ácidos graxos saturados (pré: 15,5 ± 4,7 por cento vs. pós: 6,6 ± 3,7 por cento, p=0,003) e melhora no perfil lipídico: CT (-8 por cento, p=0,033), LDL-C (-18,2 por cento, p=0,001), TG (-53 por cento, p=0,002) nos filhos de pacientes com DAC prematura que apresentavam hiperlipidemia. CONCLUSÃO: A presença de dislipidemia foi mais prevalente em adolescentes filhos de portadores de DAC prematura, mas foi responsiva à intervenção nutricional.

Prevalence of myocardial infarction is related to hyperhomocysteinemia but not influenced by C677T methylenetetrahydrofolate reductase and A2756G methionine synthase polymorphisms in diabetic and non-diabetic subjects.

BACKGROUND: Hyperhomocysteinemia has emerged as a novel risk factor for myocardial infarction (MI). Some mechanisms proposed to explain its relationship with coronary events are also shared by major coronary risk factors. We examined whether C677T methylenetetrahydrofolate reductase and A2756G methionine synthase polymorphisms could affect the relative risk for MI. METHODS: A sample of 196 individuals was divided into four groups (diabetics with MI, n=43; diabetics without MI, n=50; non-diabetics with MI, n=47; non-diabetics without MI, n=56) and compared regarding the prevalence of the polymorphisms, risk factors, and biochemical parameters. RESULTS: Higher prevalence of hyperhomocysteinemia was found in MI patients (p<0.05 vs. non-MI subjects), in males (p<0.001 vs. female) and in those > or = 65 years (p=0.01 vs. <65 years). Homocysteine was negatively associated with HDL-C (p<0.05) and glucose, although results did not reach significance (p=0.06). Similar distribution of studied polymorphisms was seen in all groups, which presented normal folate and vitamin B12 serum levels. CONCLUSIONS: Higher homocysteinemia was predominantly observed in men, presenting low HDL-C, and at advancing age. Methylenetetrahydrofolate reductase and methionine synthase polymorphisms did not contribute to risk assessment in diabetic and non-diabetic subjects presenting normal folate levels.