Polyvascular subclinical atherosclerosis in familial hypercholesterolemia: The role of cholesterol burden and gender

被引：17

作者：

Mattina, Alessandro ^{[1
,2
]}

Giammanco, Antonina ^{[1
]}

Giral, Philippe ^{[3
,4
]}

Rosenbaum, David ^{[3
,4
,7
]}

Carrie, Alain ^{[4
,5
]}

Cluzel, Philippe ^{[4
,6
,7
]}

Redheuil, Alban ^{[4
,6
,7
]}

Bittar, Randa ^{[8
]}

Beliard, Sophie ^{[9
,10
]}

Noto, Davide ^{[1
]}

Quartarone, Angelo ^{[2
]}

Averna, Maurizio ^{[1
]}

Bruckert, Eric ^{[3
,4
]}

Gallo, Antonio ^{[3
,4
,7
]}

机构：

[1] Univ Palermo, Div Internal Med & Metab Dis, Dept Biomed Internal Med & Med Specialties, Via Vespro 129, I-90127 Palermo, Italy

[2] IRCCS Ctr Neurolesi Bonibo Pulejo, Via Prov Palermo, I-95124 Messina, Italy

[3] Hop La Pitie Salpetriere, AP HP, Endocrinol & Metab Serv, Cardiovasc Prevent Unit, Paris, France

[4] Sorbonne Univ, UMR S1166, ICAN, Hop Pitie,Inserm, Paris, France

[5] Hop Univ Pitie Salpetriere Charles Foix, AP HP, Dept Biochem Endocrinol & Oncol, Obes & Dyslipidemia Genet Unit, Paris, France

[6] Grp Hosp Pitie Salpetriere, AP HP, Pole Imagerie, Dept Imagerie Cardiovasc & Radiol Intervent, Paris, France

[7] ICAN, Imaging Core Lab, Paris, France

[8] Grp Hosp Pitie Salpetriere, AP HP, Biochem Funct Unit Metab Dis, Paris, France

[9] Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France

[10] AP HM, Endocrinol Dept, Marseille, France

来源：

NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES | 2019年 / 29卷 / 10期

关键词：

Familial hyper cholesterolemia; Cholesterol burden; Calcium score; Coronary artery calcium; Atherosclerosis; Cardiovascular disease; Cardiovascular risk; Peripheral arterial atherosclerosis; CORONARY-ARTERY CALCIUM; GENERAL-POPULATION; HEART-DISEASE; RISK-FACTORS; PLAQUE; CALCIFICATIONS; PREVALENCE; MUTATIONS; SEVERITY; STENOSIS;

D O I：

10.1016/j.numecd.2019.06.015

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background and aim: Heterozygous familial hypercholesterolemia (HeFH) is a genetic disease characterized by a heterogeneous phenotype. The assessment of cardiovascular (CV) risk is challenging for HeFH. Cholesterol burden (CB) allows to estimate the lifelong exposure to high levels of cholesterol. The aim of this study was to analyze the distribution of subclinical atherosclerosis and the relationship between atherosclerosis and the CB in a sample of HeFH patients, focusing on sex-related differences. Methods and Results: 154 asymptomatic HeFH subjects underwent coronary-artery-calcium score (CACs) and Doppler ultrasound of carotid and femoral arteries. Yearly lipid profiles and HeHF history were obtained from patients' files in order to calculate total CB. Atherosclerotic burden was defined by the presence of CACs > 0 or by the presence of carotid or femoral plaque. Study population was stratified according to gender. The prevalence of CAC, carotid and femoral atherosclerosis was of 62%, 55% and 56%, respectively. Coronary district was the least involved in women, who had a higher prevalence in carotid atherosclerosis. When two vascular districts were affected, women had an increased prevalence of femoral and carotid atherosclerosis whereas men had a higher prevalence of coronary and femoral atherosclerosis. CB correlated to the presence of atherosclerosis in any of the three vascular districts with a significant increasing trend depending on the number of affected areas. Conclusions: A polyvascular atherosclerotic burden is found in asymptomatic HeFH patients. Gender differences in the territory distribution were observed. The early and lasting exposure to high cholesterol, as expressed by CB, is a major determinant of atherosclerotic burden. (C) 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

引用

页码：1068 / 1076

页数：9