[Effect of apolipoprotein E phenotypes on the response to dietary treatment of children with hypercholesterolemia]. / Efecto de los fenotipos de la apolipoproteína E en la respuesta al tratamiento dietético en niños con hipercolesterolemia.

OBJECTIVE: Our objective was to determine if apo E phenotypes have any effect on the serum lipoprotein response to dietary intervention in children with hypercholesterolemia. PATIENTS AND METHODS: We have selected 76 children with total serum cholesterol levels higher than 200 mg/dL. At diagnosis, each patient met with a member of our clinic that established dietary recommendations (total and saturated fat intake: 30 and 10%, respectively, of total energy intake). At diagnosis and after 6 months of therapy we determined a lipoprotein profile. RESULTS: After 6 months of therapy, there was only a significant change in children with phenotype E3/E4, with significant decreases in serum total cholesterol (from 247 +/- 43 to 231 +/- 47 mg/dL, p = 0.002), LDL-cholesterol (from 164 +/- 47 to 149 +/- 48 mg/dL, p = 0.002) and triglycerides (from 81 +/- 36 to 71 +/- 31 mg/dL, p = 0.028) concentrations. Absolute and % delta differences in serum lipoprotein concentrations before and after dietary treatment do not show significant differences between apo E phenotype groups. CONCLUSIONS: In the group studied, apo E phenotypes do not determine the response to a low-fat, low-cholesterol diet in children with hypercholesterolemia. To know the factors that determine the variability in the response to dietary intervention in children with hypercholesterolemia it would be interesting to study other familial and genetic factors.

[Changes in lipid profile of young persons after substitution of sunflower oil by olive oil in the diet]. / Cambios en el perfil lipídico de individuos jóvenes tras la sustitución del aceite de girasol de su dieta por aceite de oliva.

BACKGROUND AND OBJECTIVES: There is controversy in determining the effects of olive oil in the lipidic metabolism. We studied the changes produced in the lipid profile after substituting sunflower dietetic oil with virgin olive oil. POPULATION AND METHODS: We studied 154 cadets of Academia General Militar de Zaragoza (AGEMZA), analyzing their smoking habits, anthropometric measures and dietetic intake. Hematologic, biochemical and lipidic parameters were determined in venous blood samples. All sunflower dietetic oil was substituted with olive oil, without making any other qualitative-quantitative variation in the diet 10 weeks after which the morphometric and analytical evaluation was repeated, comparing both measurements. RESULTS: 87% of cadets took part in the study. 34.3% of them were smokers. There were no significant anthropometric changes. After the interventional period, there was a decrease of 12.2% in total cholesterol (166.6 vs 146.2 mg/dl; p < 0.0001), 13.5% in LDL-cholesterol (99.7 vs 86.2 mg/dl; p < 0.0001), 12.2% in triglycerides (71.1 vs 62.4 mg/dl; p < 0.0001), 9.9% in HDL-cholesterol (52.6 vs 47.4 mg/dl; p < 0.001), despite which total-cholesterol/HDL-cholesterol ratio increased 3.1% (3.2 +/- 0.7 vs 3.1 +/- 0.7; p < 0.001). There were no changes in Lp(a) plasmatic concentrations or hematologic or biochemical parameters. CONCLUSION: The improvement of the lipidic parameters can only be explained by the use of olive oil in the diet of the AGEMZA cadets.

[Atherogenic risk factors in children of parents with ischemic heart disease]. / Factores de riesgo aterogénico en hijos de padres con cardiopatía isquémica.

We have studied serum lipid levels and dietetic intake in 38 children whose parents had ischemic heart disease (HPCI) before 55 years of age and in a control group (n = 114). In the HPCI group, 25% had serum levels of total cholesterol higher than 200 mg/dl; only 2 children presented elevated levels of LDL and apo B. Dietetic intakes in both groups were similar, with a high protein (16-17% of calories) and fat (39-42% of calories) intake and a low carbohydrate intake (40.46% of calories). In both groups the percentage of monounsaturated fat was higher than other types of fat. The most frequent phenotype in the HPCI group was IIa (8 children). Only 1 child showed a IIb phenotype. This finding may be due to the variability of this phenotype in the same individual throughout life. In the families (n = 8), we have detected 2 families with polygenic hypercholesterolemia (HP), 2 others with familial combined hyperlipidemia (HFC) and 4 without family history of hyperlipidemia. Taking into account the lipid profile in children of the HPCI group, we have detected the presence of familial dysliproproteinemias. It appears that dietetic intake is not an atherogenic risk factor in these patients.

[Primary dyslipoproteinemias in a child-adolescent population of Aragón detected by two methods: selective search and targeted search]. / Dislipoproteinemias primarias en una población infanto-juvenil aragonesa detectadas mediante dos estrategias: búsqueda selectiva y búsqueda oportunista.

A series of 439 children (245 boys and 194 girls) ranged between 2.0 and 18.0 years of age have been studied January 1987 to April 1990. They belonged to four groups: I) 306 children (163 boys and 143 girls), "control group"; II) 31 children (22 boys and 9 girls) whose parents had some type of dyslipoproteinemia (HPDLP); III) 38 children (24 boys and 14 girls) whose fathers were survivors of myocardial infarction occurred before 55 years of age (HPCI); and IV) 43 children (23 boys and 20 girls) who had, at least in two occasions, more than three months of time separated between then, over 200 mg/dL of total serum cholesterol levels detected by opportunist search (HDC). For children's identification of risk factors to develop atherosclerotic disease during adult life, two different types of strategy has been utilised. One, "selective search", taking into account children of groups II (HPDLP) and III (HPCI). Other, "opportunist search", taking into consideration children of group IV (HDC). The most frequent primary dyslipoproteinemia between the families of children with high serum levels has been Polygenic Hypercholesterolemia (HP). In the second place were both Familial Hypercholesterolemia (HF) an Familial Combined Hyperlipidemia (HFC). A family with Mixed Hyperlipidemia (HM) was also identified. Familial aggregation, with relation to serum lipid levels, were detected in children of the three groups: HPDLP, HPCI and HDC, as it is reported by another authors. Our results suggest the genetic alterations may contribute to the presence of different types of dyslipoproteinemia in children.

[Hyperapo-beta-emia in children. Study of 17 families]. / Hiperapo-beta-emia en niños. Consideraciones a propósito de 17 familias.

Apolipoprotein (apo)-beta is an atherosclerotic risk factor in adults and children. In families with Familial Combined Hyperlipidemia (FCH) it has been described as a lipoprotein phenotype called Hyperapobetalipoproteinemia (Hyperapo-beta) and characterized by increased numbers of small, dense and apo-beta enriched low density lipoproteins. In our Lipids Clinic, we have studied 267 children, but for the purpose of this paper we have only taken into account the 19 of these children who showed increased plasma total apo-beta levels (Hyperapo-beta-emina). To investigate the type of dyslipoproteinemia of these children, we divided them into two groups: 1) Group 1: 10 children with apo-beta levels greater than mean + 2 standard deviations (SD); 2) Group 2: 9 children with apo-beta levels greater than mean + 3 SD. We have also studied the fathers, mothers, brothers and sisters of all the children. Only one child (Group 1) had type IIb hyperlipoproteinemia. The other children had type IIa hyperlipoproteinemia. In each group, 4 families had FCH and the others had either Familial Hypercholesterolemia or Polygenic Hypercholesterolemia. Families with FCH could also have hyperapo-beta. It is possible that in the future some children of FCH families and those with type IIa hyperlipoproteinemia will have increased plasma triglyceride levels. This could be prevented by a proper diet.

[Lipids, lipoproteins, apoproteins and physical exercise in young female athletes]. / Lípidos, lipoproteínas, apoproteínas y ejercicio físico en jóvenes deportistas del sexo femenino.

Body composition, lipid, lipoprotein and apoprotein profiles were evaluated in 38 female adolescents, with ages from 11.5 to 15.0 years, and arranged in three groups: controls, swimmers and rhythmic gymnasts. Body composition showed evident differences when comparing gymnasts with controls and swimmers. Lowest levels for NEFA corresponded to gymnasts. HDL-C was higher in sports girls with respect to controls, mainly in gymnasts. Gymnasts appeared to have significantly higher Apo A1 differences when comparing them with controls and swimmers. HDL-C/CT, HDL-C/LDL-C, HDL-C/Apo A1/Apo B ratios demonstrated higher levels in sports girls, and mostly in gymnasts. Most significative correlations were found between body composition and Apo A1 and Apo A1/Apo B in control and swimming groups. Thus, physical activity at early ages has a beneficial effect on HDL-C and Apo A1 concentrations. Differences between sports girls and controls are more significantly revealed by lipid, lipoprotein and apoprotein relating ratios. Rhythmic gymnasts do seem to have a different lipidic pattern when compared to controls and swimmers.

[Bisalbuminemia and pseudobisalbuminemia: clinical significance (author's transl)]. / Bisalbuminemia y seudobisalbuminemia: significación clinica.

Two cases of bisalbuminaemia are hereby studied: a congenital case and an acquired or transitory case. In the first one, this hereditary disturbance is studied on four affected members of one Spanish family, being associated in two of them with multiple lipomatosis. This kind of association is considered as casual. As in most of the informed cases, ours belongs to the slow kind. The second case deals with a bisalbuminaemia of transitory character or pseudobisalbuminaemia which, appeared in a woman in the course of an acute pancreatitis of biliolithiasic origin, with a pancreatic pseudocyst and pleural effusion, the evolution in the inflamatory pancreatic process being advantageous in spite of the prsence of bisalbuminaemia. Briefly revised, are exposed the causes of this interesting and rare alteration in the electrophoretic fractioning of plasmatic proteins: congenital, and adquired causes due to administration of betalactamines and during the course of acute pancreatitis.