The influence of menarche of high cholesterol level in adolescent girls with familial hypercholesterolemia
Authors:
J. Hyánek 1; L. Dubská 1; V. Martiníková 1; J. Privarová 1; H. Přindišová 2; M. Zagyiová 1; L. Táborský 1
Authors‘ workplace:
Metabolická ambulance a Oddělení klinické biochemie, hematologie, imunologie, Nemocnice Na Homolce, Praha primář MUDr. L. Táborský
1; Radiodiagnostické oddělení, Nemocnice Na Homolce, Prahaprimář prof. MUDr. J. Vymazal, DrSc.
2
Published in:
Čes-slov Pediat 2013; 68 (1): 12-19.
Category:
Original Papers
Overview
Menarche (first menstruation hemorrhage) due to increasing levels of sexual hormones decrease the total cholesterol level (TCH) in some girls with familial hypercholesterolemia (FH) up to 3–5 mmol/l. In the past this experience resulted in recommendation to begin with the pharmacological therapy of FH in girls only after menarche. Our experience however does not correspond to that.
In 20 girls at the age of 10–16 years diagnosed FH we had a chance to follow cholesterolemia in the course of their pharmacological therapy and in the last 20 years we observed the following relations to menarche:
- a) In 70% of patients with marked entry hypercholesterolemia (>8.0 mmol/l TCH) the decreased levels were fund to be only transitory and after several menstruation ccles the level of TCH returned to original high levels if the pharmacological therapy was not applied.
- b) In 30% of patients with inconspicuous hypercholesterolemia (6–8.0 mmol/l) half of them experienced lasting normal level of TCH which did not require pharmacological treatment. In the remaining 15% of girls with inconspicuous TCH level gradually increasing after several menstruations cycles to previous high levels and these patients require permanent pharmacological, optimally combined, therapy (ezetimib + statin).
Conclusion:
Our experience suggests a new recommendation to begin pharmacological therapy of FH in selected female patients with marked form of HC documented by mutation of LDL-receptor as early as in 8 years of life in the same was recommended in boys.
Key words:
familial hypercholesterolemia, menarche, high cholesterol level changes after menarche, adolescent girls
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Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2013 Issue 1
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