Diet, Endothelial Function and Pediatric Hyperlipidemia

在美国，冠心病(CHD)仍然是主要的死亡原因。患有以下疾病的儿童 胆固醇水平升高尤其容易发生，也是早发冠心病的高危因素。内皮细胞 功能障碍是冠状动脉粥样硬化的最早阶段，在胆固醇升高的儿童中存在。 水平早在8岁时就达到了。这项研究的长期目标是开发饮食干预措施 常见血脂紊乱儿童内皮功能障碍的预防和治疗 家族性高胆固醇血症(FH)和家族性混合性高脂血症(FCH)。越来越多的证据表明 地中海饮食和鱼中发现的？-3脂肪酸具有心脏保护作用。的具体目标 这项研究的目的是：确定地中海饮食是单独食用还是与？-3脂肪酸混合食用 (二十碳五烯酸、二十二碳六烯酸或二十碳五烯酸和二十二碳六烯酸)改善 内皮功能；评价饮食干预对血脂和脂蛋白亚类的影响； 评估饮食干预对氧化应激和炎症生物标志物的影响。这 这项研究是一项随机、双盲、安慰剂对照的临床试验，包括102名儿童(8-18岁) 用地中海饮食和？-3脂肪酸补充剂治疗。饮食教育行为 干预将在6个月内进行，包括个人咨询、小组会议和互动 基于Web的程序。血管内皮细胞功能将通过高分辨率超声无创测量。 分别于基线、6周、12周、18周、24周观察肱动脉。这项研究是独一无二的，因为它是一种新的干预 专为早期CHD高危儿童设计，饮食成分和补充？-3脂肪 酸。如果有效，这种干预将被广泛应用，并为饮食疗法提供有价值的见解 预防高脂血症儿童冠心病的进展。

Coronary heart disease (CHD) continues to be the leading cause of death in the United States. Children with elevated cholesterol levels are especially vulnerable and are at high risk for early onset CHD. Endothelial dysfunction, the earliest phase of coronary atherosclerosis, is present in children with elevated cholesterol levels as early as 8 years of age. The long term objective of this study is to develop dietary interventions for the prevention and treatment of endothelial dysfunction in children with common lipid disorders including familial hypercholesterolemia (FH) and familial combined hyperlipidemia (FCH). Increasing evidence suggests that the Mediterranean diet and ?-3 fatty acids found in fish have cardioprotective effects. The specific aims of the study are to: determine whether a Mediterranean diet alone or combined with ?-3 fatty acids (eicosapentaenoic acid, docosahexaenoic acid or eicosapentaenoic & docosahexaenoic acids) improve endothelial function; evaluate the effects of the dietary interventions on lipids and lipoprotein subclasses; evaluate the effects of the dietary interventions on biomarkers for oxidative stress and inflammation. This study is a randomized, double-blind, placebo-controlled clinical trial that includes 102 children (ages 8-18) treated with the Mediterranean diet and ?-3 fatty acid supplements. A dietary educational behavioral intervention will be conducted over 6 months with individual counseling, group sessions and an interactive web-based program. Endothelial function will be measured non-invasively by high resolution ultrasound of the brachial artery at baseline, 6, 12, 18 and 24 weeks. This study is unique because it is a new intervention designed for children at high risk for early CHD with a dietary component and supplementation with ?-3 fatty acids. If effective, this intervention would be broadly applicable and lend valuable insight about dietary therapy to prevent the progression of CHD in hyperlipidemic children.