FH more severe with maternal inheritance
MedWire News: Familial hypercholesterolemia (FH) patients have worse lipid profiles if they inherit the condition from their mothers than if they get it from their fathers, show results from a large study.
"Although the differences are rather small, they all point in the same direction, indicating that maternal FH leads to a more atherogenic lipid profile, which may increase the already existing cardiovascular disease risk in the FH offspring," say Barbara Hutten (Academic Medical Center, Amsterdam, The Netherlands) and co-workers.
They add: "We speculate that cholesterol synthesis and excretion is to some extent affected by maternal cholesterol levels during pregnancy in utero, which may cause increased low-density lipoprotein (LDL) cholesterol levels and, subsequently, an increased risk for the development of atherosclerosis in the offspring later in life."
The team found small but significant increases in levels of atherogenic lipids among 1069 FH patients with maternally inherited FH relative to levels in 1270 patients who inherited the condition from their fathers.
Total cholesterol levels were 0.156 mmol/l (6.04 mg/dl) higher in patients with maternally inherited FH than in those with paternally inherited FH, after accounting for gender and country of origin (Canada or The Netherlands).
LDL cholesterol levels were 0.187 mmol/l (7.24 mg/dl) higher after adjusting for gender, country, and high-density lipoprotein (HDL) cholesterol levels, while apolipoprotein (apo)B levels were 0.064 g/l higher after accounting for HDL cholesterol and triglycerides.
Levels of HDL cholesterol, apoA-1, and triglycerides did not significantly differ between the two groups of patients, the researchers report in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.
They conclude: "Although the molecular mechanisms underlying these observations still require elucidation, our data suggest that maternal hypercholesterolemia during pregnancy may program lipid metabolism to a certain extent in the fetus."
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By Eleanor McDermid