Comparison of lipid profile values in pediatric patients with cyanotic and acyanotic congenital heart disease

  • Fifi Febria Ningsih Faculty of Medicine, University of Sumatera Utara
  • Hafaz Zakky Abdillah Department of Child Health, Universitas Sumatera Utara Medical School, Medan, South Sumatera
  • Selvi Nafianti Department of Child Health, Universitas Sumatera Utara Medical School, Medan, South Sumatera
Keywords: congenital heart disease; dyslipidemia; cyanotic

Abstract

Background Incidence of congenital heart disease (CHD) is about 0.8% of every child born. This heart defect is associated with dyslipidemia in children. Lipid profiles examination in patients with CHD can be used to determine risk factors for atherosclerosis.

Objective To examine differences in lipid profiles in children with cyanotic and acyanotic CHD.

Methods This was a cross-sectional study on 60 pediatric CHD patients at Haji Adam Malik Hospital, Medan, North Sumatera, from December 2020 to March 2021. Subjects were included by consecutive sampling. Data of patient’s age, gender, weight, height, complete blood count, blood glucose, and lipid profiles were recorded. Unpaired T-test analysis and Mann-Whitney test were then performed to analyze variables in cyanotic and acyanotic CHD patients.

Results Of a total of 60 CHD children, 26 subjects had a diagnosis of cyanotic CHD and 34 subjects had a diagnosis of acyanotic CHD. The most common cause of cyanotic CHD was tetralogy of Fallot (76.9%), while the most common cause of acyanotic CHD were ventricular septal defect and patent ductus arteriosus (32.4% each). Analysis of lipid profiles on both groups revealed that low density lipoprotein (LDL) was significantly lower in the cyanotic group than in the acyanotic group (P<0.05). However, other lipid profile values, were not significantly different between groups. In addition, there was no significant difference in incidence of dyslipidemia between cyanotic and acyanotic CHD.

Conclusion Low density lipoprotein is significantly lower in the cyanotic CHD group than in the acyanotic CHD group. But there are no significant differences in the other lipid profiles measurement and incidence of dyslipidemia between groups.

References

1. Sastroasmoro S, Madiyono B. Epidemiologi dan etiologi penyakit jantung bawaan. In: Sastroasmoro S, Madiyono B, editors. Buku ajar kardiologi anak. Jakarta: IDAI; 1994. p. 165-190.
2. Djer MM, Madiyono B. Tata laksana penyakit jantung bawaan. Sari Pediatri. 2000;2:155-162. DOI: https://dx.doi.org/1014238/sp2.3.2000.155-62.
3. Shustak RJ, McGuire SB, October TW, Phoon CKL, Chun AJL. Prevalence of obesity among patients with congenital and acquired and heart disease. Pediatr Cardiol. 2012;33:8-14. DOI: https://dx.doi.org/10.1007/s00246-011-0049-y.
4. Hansen SR, Dørup I. Energy and nutrient intakes in congenital heart disease. Acta Paediatr. 1993 Feb;82(2):166-72. DOI: https://doi.org/10.1111/j.1651-2227.1993.tb12632.x. PMID: 8477162.
5. Fakhrzadeh H, Tabatabaei-Malazy OT. Dyslipidemia and cardiovascular disease. 2012. [cited 2022 OCT 10].p. 303-20. Available from: https://cdn.intechopen.com/pdfs/27503/InTech-Dyslipidemia_and_cardiovascular_disease.pdf.
6. Chikanna S, Upadhyay A, Aneja GK. Lipid profile in high risk children aged 2-10 years. Indian Pediatr. 2010;47:630-1. PMID: 20683118.
7. Giamberti A, Lo Rito M, Conforti E, Varrica A, Carminati M, Frigiola A, et al. Acquired coronary artery disease in adult patients with congenital heart disease: a true or a false problem? J Cardiovasc Med. 2017;18:605-9. DOI: https://doi.org/10.2459/JCM.0000000000000495.
8. Perloff JK. The coronary circulation in cyanotic congenital heart disease. Int J Cardiol. 2004;97:79–86. DOI: https://doi.org/10.1016/j.ijcard.2004.08.018.
9. Wilson DP, McNeal C, Blackett P. Pediatric dyslipidemia: recommendations for clinical management. South Med J. 2015 Jan;108(1):7-14. DOI: https://doi.org/10.14423/SMJ.0000000000000219. Erratum in: South Med J. 2016 Feb;109(2):137. PMID: 25580750.
10. Dawson-Hahn EE, Pak-Gorstein S, Hoopes AJ, Matheson J. Comparison of the nutritional status of overseas refugee children with low income children in Washington State. PLoS One. 2016;11:e0147854. DOI: https://doi.org/10.1371/journal.pone.0147854
11. Hoffman JIE. Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002:39:1890–900. DOI: https://doi.org/10.1016/S0735-1097(02) 01886-7.
12. Wulandari AP, Ontoseno T, Umiastuti P. Hubungan status gizi anak usia 2-5 tahun dengan kelainan jantung bawaan biru di RSUD Dr Soetomo Surabaya. Sari Pediatri. 2018;20:65-9.
13. Liu Y, Chen S, Zühlke L, Babu-Narayan SV, Black GC, Choy MK, Li N, Keavney BD. Global prevalence of congenital heart disease in school-age children: a meta-analysis and systematic review. BMC Cardiovasc Disord. 2020;20:488. DOI: https://doi.org/10.1186/s12872-020-01781-x.
14. Khasawneh W, Hakim F, Abu Ras O, Hejazi Y, Abu-Aqoulah A. Incidence and Patterns of Congenital Heart Disease Among Jordanian Infants, a Cohort Study From a University Tertiary Center. Front Pediatr. 2020 May 5;8:219. DOI: https://doi.org/10.3389/fped.2020.00219.
15. Modi P, Suleiman MS, Reeves BC, Pawade A, Parry AJ, Angelini GD, Caputo M. Basal metabolic state of hearts of patients with congenital heart disease: the effects of cyanosis, age, and pathology. Ann Thorac Surg. 2004;78:1710-6. DOI: https://doi.org/ 10.1016/j.athoracsur.2004.05.010.
16. Wisnuwardhana M. Manfaat pemberian diet tambahan terhadap pertumbuhan pada anak dengan penyakit jantung bawaan asianotik. Semarang: Universitas Diponegoro; 2006. [cited 2022 Oct 10]. Available from: http://eprints.undip.ac.id/18130/.
17. Forchielli ML, McColl R, Walker WA, Lo C. Children with congenital heart disease: a nutrition challenge. Nutr Rev. 1994;52:348-53. DOI: https://doi.org/10.1111/j.1753-4887.1994.tb01359.x.
18. Park KM. Dyslipidemia and other cardiovascular risk factors. In: Park MK, editor. Park’s pediatric cardiology for practitioners. 6th ed. Philadelphia: Mosby Elsevier; 2008. p. 852-900.
19. Barbiero SM, Sica CD, Schuh DS, Cesa CC, Petcowicz RO, Pellanda LC. Overweight and obesity in children with congenital heart disease: combination of risks for the future?. BMC Pediatr. 2014;14;271. DOI : https://doi.org/10.1186/1471-2431-14-271.
20. Fuenmayor C, Redondo ACC, Shiraishi KS, Souza R, Elias PF, Jatene IB. Prevalence of dyslipidemia in children with congenital heart disease. Arq Bras Cardiol. 2013;101:273-6. DOI: https://doi.org/10.5935/abc.20130174.
21. Justino H, Khairy P. Congenital heart disease and coronary atherosclerosis: a looming concern?. Canadian Journal of Cardiology. 2013;29:757-58. DOI: https://doi.org/10.1161/CIRCULATIONAHA.118.037064.
22. Ference BA, Ginsberg HN, Graham I, Ray KK, Packard CJ, Bruckert E, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2017;38:2459–72. DOI: https://doi.org/10.1093/eurheartj/ehx144.
23. Fyfe A, Perloff JK, Niwa K, Child JS, Miner PD. Cyanotic congenital heart disease and coronary artery atherogenesis. Am J Cardiol. 2005;96:283-90. DOI: https://doi.org/10.1016/j.amjcard.2005.03.060.
24. Welty FK, Ordovas J, Schaefer EJ, Wilson PW, Young SG. Identification and molecular analysis of two apoB gene mutations causing low plasma cholesterol levels. Circulation. 1995;92:2036-40. DOI: https://doi.org/10.1161/01.cir.92.8.2036. PMID: 7554178.
25. Gilbert HS, Ginsberg H, Fagerstrom R, Brown WV. Characterization of hypocholesterolemia in myeloproliferative disease. Relation to disease manifestations and activity. Am J Med. 1981;71:595-602. DOI: https://doi.org/10.1016/0002-9343(81)90212-6.
Published
2022-12-05
How to Cite
1.
Ningsih F, Abdillah H, Nafianti S. Comparison of lipid profile values in pediatric patients with cyanotic and acyanotic congenital heart disease. PI [Internet]. 5Dec.2022 [cited 12Nov.2024];62(6):404-. Available from: https://www.paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2754
Section
Pediatric Cardiology
Received 2021-08-20
Accepted 2022-12-05
Published 2022-12-05