HYPERLIPIDEMIA IN CHILDREN - THE ROLE OF UREMIA, STEROIDS AND CYCLOSPORINE THERAPY

At present, there are very few studies that look at the effect of urem ia, prednisone and cyclosporine therapy on the lipid profiles of child ren. This effect is important because of the potential association of hyperlipidemia and increased risk of cardiovascular morbidity and mort ality and glomerulosclerosis. We measured fasting lipid profiles in 73 children. There were 21 controls, 18 patients treated with cyclospori ne and prednisone, 9 patients treated with cyclosporine alone and 25 d ialysis patients. Lipoprotein (a) levels were measured using direct bi nding 'sandwich' ELISA. Uremic children had higher levels of triglycer ides and very-low-density lipoprotein as compared with the control gro up. Children receiving combination of cyclosporine and prednisone also had higher total cholesterol, triglycerides, low-density lipoprotein, very-low-density lipoprotein as compared to the control group. Howeve r, children receiving cyclosporine monotherapy had lipid profiles simi lar to the control group. Patients receiving cyclosporine and predniso ne had higher total cholesterol, high-density lipoprotein and low-dens ity lipoprotein as compared with the dialysis group. Evaluating lipopr otein (a) levels, children on cyclosporine monotherapy had lower lipop rotein (a) levels as compared with children on dialysis and those rece iving both combination therapy. The total cholesterol/high-density lip oprotein-cholesterol ratio (TC/HDL) was similar among the study groups . In summary, uremic children and children receiving steroids with cyc losporine have elevated lipid levels. However, the increased risk for atherosclerosis is not evident because of similar levels of lipoprotei n (a) and TC/HDL ratios among the study groups.