Reduced apolipoprotein E-rich high-density lipoprotein level at birth is restored to the normal range in patients with familial hypercholesterolemia in the first year of life.
BACKGROUND
High-density lipoprotein (HDL) consists of apolipoprotein E (apoE)-rich and apoE-poor HDL particles. ApoE-rich HDL level is high at birth but decreases after birth with reciprocal elevation in low-density lipoprotein (LDL)-cholesterol.


OBJECTIVE
The objective of the study was to clarify whether apoE-rich HDL decreases after birth in children with familial hypercholesterolemia (FH), a disorder caused by impaired LDL clearance.


METHODS
We measured apoE-rich HDL-cholesterol and LDL-cholesterol during the first year of life in 10 FH children (one homozygote and nine heterozygotes), 12 non-FH siblings, and 75 healthy controls.


RESULTS
At birth, apoE-rich HDL-cholesterol was undetectable in a homozygous FH child and lower in heterozygous FH children than non-FH siblings and controls (4+/-2 vs. 12+/-4 and 11+/-4 mg/dl, P<0.001). At 3-4 months, apoE-rich HDL-cholesterol increased in homozygous and heterozygous FH children and decreased in non-FH siblings and controls. At 12 months, apoE-rich HDL-cholesterol levels were similar among these four groups (6-7 mg/dl). In contrast, LDL-cholesterol concentration was always twice as high in heterozygous FH children as non-FH siblings and controls (at birth, 50+/-15 vs. 25+/-7 and 25+/-5 mg/dl, P<0.001; at 3-4 months of age, 159+/-29 vs. 71+/-16 and 73+/-15 mg/dl, P<0.001; at 12 months of age, 156+/-29 vs. 75+/-18 and 76+/-17 mg/dl, P<0.001).


CONCLUSIONS
ApoE-rich HDL level is low at birth in FH children and increases to the normal level in the first year of life, opposite to the change in normal children.
Nagasaka
Hironori
H
Division of Metabolism, Chiba Children's Hospital, 579-1 Heta Cho, Midori-Ku, Chiba, Japan. nagasa-hirono@k2.dion.ne.jp
Miida
Takashi
T
Hirano
Kenichi
K
Ota
Akemi
A
Yorifuji
Tohru
T
Takatani
Tomozumi
T
Tsukahara
Hirokazu
H
Takayanagi
Masaki
M
Hui
Shu-Ping
SP
Kobayashi
Kunihiko
K
Chiba
Hitoshi
H
D001057:Apolipoproteins E / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012016:Reference Values
D001057:Apolipoproteins E; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL