Acute infections in children are accompanied by oxidative modification of LDL and decrease of HDL cholesterol, and are followed by thickening of carotid intima-media.
BACKGROUND
Atherosclerosis begins early in life. Infections might contribute to the pathogenesis of atherosclerosis. In this study, we investigated whether acute infections in children could alter the carotid wall morphology and the lipid profile.


METHODS
Mean carotid intima-media thickness (IMT) was measured by high-resolution ultrasound in 28 hospitalised children (mean age: 5+/-2 years), who fulfilled the diagnostic criteria of acute infections (body temperature, >38 degrees C; C-reactive protein, >15mg/ml, and clinical), and in 20 age- and gender-matched controls. Antibodies against oxidised low-density lipoprotein (anti-oxLDL antibodies), as well as total and high-density lipoprotein cholesterol (HDL-C) were analysed in all children. The infection group was investigated both during the acute illness and 3 months after clinical recovery (post-infection).


RESULTS
During the acute illness, the infection group had elevated anti-oxLDL antibodies and decreased HDL-C, as compared to those obtained at 3 months and in controls (p<0.05). These changes in the infection group were followed, at 3 months, by thickening of carotid intima-media. Those who received antibiotics during their acute illness had less carotid thickening than those who were not treated with antibiotics (p<0.05).


CONCLUSIONS
Acute infections in children seem to be accompanied by enhanced oxidative modification of LDL and by decrease in HDL-C. These lipid changes may be followed by thickening of carotid artery intima-media. These findings suggest that, in childhood, acute infections could be associated with increased risk of atherosclerosis, and warrant further studies on this topic.
Liuba
Petru
P
Division of Pediatric Cardiology, Department of Paediatrics, Lund University Hospital, Sweden. petru.liuba@pedi.lu.se
Persson
Jerker
J
Luoma
Jukka
J
Ylä-Herttuala
Seppo
S
Pesonen
Erkki
E
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000906:Antibodies / Q000032:analysis; D002340:Carotid Artery Diseases / Q000378:metabolism* / Q000473:pathology; D017536:Carotid Artery, Common / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D006801:Humans; D007239:Infections / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D008077:Lipoproteins, LDL / Q000276:immunology; D010084:Oxidation-Reduction; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media
D000900:Anti-Bacterial Agents; D000906:Antibodies; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein