Abstract 1399: Arterial Characteristics in Familial Combined Hyperlipidemia: aA Meta-Analysis of Case-Control Studies
Objective: We conducted this research to calculate quantitative estimates for the impact of familial combined hyperlipidemia (FCH) on flow-mediated dilation of the brachial artery (FMD, a measure of endothelial function) and carotid intima-media thickness (IMT, a measure of subclinical atherosclerosis), which comprise predictors of cardiovascular risk.
Methods: After a systematic review of the literature, we identified 4 case-control studies that report data on FMD and 7 studies that report data on carotid IMT in untreated FCH patients and controls.
Results: Patients with FCH had significantly lower FMD compared with controls [pooled weighted mean difference (WMD) of FMD: −0.90% (95% CI −1.72 to −0.08%, P<0.05, figure A⇓]. Carotid IMT was significantly higher in FH patients [pooled WMDs of 0.51 mm (95% CI 0.32 to 0.71 mm), P<0.001, figure B⇓]. Meta-regression analysis showed an inverse relationship between age and FMD difference (p<0.01), indicating a higher impairment of FMD at young FCH subjects (vs controls of similar age) compared to older patients with FCH. We also observed a significant association of the WMD of carotid IMT with the difference of total cholesterol between FH patients and controls (both P<0.05), indicating a potential role of lipid levels in subclinical atherosclerosis in FCH patients.
Conclusions: Subjects with FCH have impaired endothelial function and a higher degree of subclinical atherosclerosis compared with controls. These changes depend, at least partly, on age and cholesterol level, and may explain the high cardiovascular risk observed in patients with FCH.