Dyslipidemia in Children With Arterial Ischemic Stroke: Prevalence and Risk Factors

Sally Sultan, Michael Dowling, Adam Kirton, Gabrielle DeVeber, Alexandra Linds, Mitchell S.V. Elkind, Tim Bernard, Michael Dowling, Marta Hernandez, Michael Rivkin, Ilona Kopyta, Rebecca Ichord, Susan Benedict, Mark Mackay, Adam Kirton, Dimitrios Zafeiriou, Monica Troncoso, Jerome Yager, Lisa Abraham, Warren LoVeronica Gonzalez, Montri Saengpattrachai, Anthony Chan, Abdallah Abdallah, Vesna Brankovic-Sreckovic, Anneli Kolk, Jessica Carpenter, Gordana Kovacevic, Catherine Amlie-Lefond, Maja Steinlin, Juliann Paolicchi, Monroe Carell, Bruce Bjornson, Barry Kosofsky, Virginia Wong, Paola Pergami, Neil Friedman, Yang Guang, Peter Humphreys, Ulrike Nowak-Göttl, Donna Ferriero, Frederico Xavier, Robert Fryer, Lucila Andrade Alveal, Diana Altuna, Ryan Felling, Steven Pavlakis, Eric Grabowski, Meredith Golomb, Michael Noetzel, Chaouki Khoury, Norma Lerner, Amanda Blair, Mubeen Rafay

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background Risk factors for pediatric stroke are poorly understood and require study to improve prevention. Total cholesterol and triglyceride values peak to near-adult levels before puberty, a period of increased stroke incidence. The role of lipids in childhood arterial ischemic stroke has been minimally investigated. Methods We performed a cross-sectional analysis of lipid and Lp(a) concentrations in children with arterial ischemic stroke in the International Pediatric Stroke Study to compare the prevalence of dyslipidemia and high- or low-ranking lipid values in our dataset with reported population values. We analyzed sex, body mass index, race, ethnicity, family history, and stroke risk factors for associations with dyslipidemia, high non–high-density lipoprotein cholesterol, and hypertriglyceridemia. Results Compared with the National Health and Nutrition Examination Survey, a higher proportion of children ≥5 years with arterial ischemic stroke had dyslipidemia (38.4% versus 21%), high total cholesterol (10.6% versus 7.4%), high non–high-density lipoprotein cholesterol (23.1% versus 8.4%), and low high-density lipoprotein cholesterol (39.8% versus 13.4%). The lipid values that corresponded to one standard deviation above the mean (84th percentile) in multiple published national studies generally corresponded to a lower ranking percentile in children aged five years or older with arterial ischemic stroke. Dyslipidemia was more likely associated with an underweight, overweight, or obese body mass index compared with a healthy weight. Ethnic background and an acute systemic illness were also associated with abnormal lipids. Conclusions Dyslipidemia and hypertriglyceridemia may be more prevalent in children with arterial ischemic stroke compared with stroke-free children.

Original languageEnglish (US)
Pages (from-to)46-54
Number of pages9
JournalPediatric neurology
Volume78
DOIs
StatePublished - Jan 2018

Keywords

  • body mass index
  • lipids
  • pediatric stroke
  • prevalence
  • risk factors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neurology
  • Developmental Neuroscience
  • Clinical Neurology

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