Low-density lipoprotein levels and not mutation status predict intima-media thickness in familial hypercholesterolemia

Ann Vasc Surg. 2014 Feb;28(2):421-6. doi: 10.1016/j.avsg.2013.02.024. Epub 2013 Oct 9.

Abstract

Background: Intima-media thickness (IMT) is a well-described marker of cardiovascular disease. In this study we aim to determine whether low-density lipoprotein (LDL) levels and disease-related mutation status can predict IMT in patients with severe familial hypercholesterolemia (FH) referred for or on LDL apheresis.

Methods: Genetic screening, lipid profile testing, and IMT measurements were performed on a series of 33 severe FH patients (19 homozygous) on LDL apheresis treatments (LDL 447 ± 151 mg/dL, age range 6-60 years). Data were then compared with literature IMT-LDL data for normal subjects, mild FH patients, and severe FH patients (18, 41, and 6 studies, respectively).

Results: Age-adjusted IMT was linearly related to LDL levels over a wide range of values (<500 mg/dL), except for the severe FH no-apheresis cohort. Alternatively, our severe FH population (mostly on apheresis) did follow the mild FH/control age-adjusted IMT-LDL relation.

Conclusions: In severe FH, measuring LDL levels is more predictive of increased IMT than genetic screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Apolipoproteins E / genetics
  • Biomarkers / blood
  • Blood Component Removal
  • Carotid Artery Diseases / blood
  • Carotid Artery Diseases / diagnosis
  • Carotid Artery Diseases / etiology*
  • Carotid Artery Diseases / genetics
  • Carotid Intima-Media Thickness*
  • Case-Control Studies
  • Child
  • DNA Mutational Analysis
  • Genetic Predisposition to Disease
  • Genetic Testing / methods
  • Heterozygote
  • Homozygote
  • Humans
  • Hyperlipoproteinemia Type II / blood
  • Hyperlipoproteinemia Type II / complications*
  • Hyperlipoproteinemia Type II / diagnosis
  • Hyperlipoproteinemia Type II / genetics
  • Hyperlipoproteinemia Type II / therapy
  • Lipoproteins, LDL / blood*
  • Middle Aged
  • Mutation*
  • Phenotype
  • Predictive Value of Tests
  • Receptors, LDL / genetics
  • Risk Factors
  • Severity of Illness Index
  • Young Adult

Substances

  • Apolipoproteins E
  • Biomarkers
  • LDLR protein, human
  • Lipoproteins, LDL
  • Receptors, LDL