General analysis of clinical and laboratory characteristics of the Ukrainian familial hypercholesterolemia registry

O. Mitchenko, V. Romanov, I. P. Vakaluk, A. Isayeva, L. Rudenko, N. M. Chulaevska, K. Timokhova
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Abstract

The aim – to evaluate clinical and laboratory characteristics of patients of the Ukrainian familial hypercholesterolemia registry taking into account gender differences.Materials and methods. 231 patients with familial hypercholesterolemia were included to the Ukrainian Familial Hypercholesterolemia Registry: 8 children (under 18 years of age) and 223 adult patients (68 men (30.5 %), mean age 43.4±1.3 and 155 women) 69.5 %) – 45.5±1.0 years) with familial hypercholesterolemia verified according to the DLCN criteria. General clinical, laboratory, instrumental examinations and genetic testing were performed.Results and discussion. In the general registry among the patients with familial hypercholesterolemia in the setting of early manifestation of atherosclerosis the male patients with familial hypercholesterolemia were more likely to have coronary artery disease, premature coronary artery disease, cerebral and peripheral atherosclerosis, xanthoma, hypertriglyceridemia, diabetes mellitus, smoking and a history of MI, which caused a higher DLCN score (9.3 points in men against 7.8 points in women, p<0,05). Female patients with familial hypercholesterolemia had a higher percentage of obesity and hypertension, which corresponds to the main gender trends of the Ukrainian population study.Conclusions. Since 2017, for the first time in Ukraine, the register of patients with familial hypercholesterolemia has been initiated. In December 2019 the most severe form – homozygous familial hypercholesterolemia – was first included in the list of orphan diseases by the Order of the Ministry of Health of Ukraine. According to the analysis of the data of the Ukrainian familial hypercholesterolemia registry, this pathology is diagnosed rather late and insufficiently in Ukraine. In patients with familial hypercholesterolemia, against the background of an earlier manifestation of atherosclerotic lesions, gender features of the cardiovascular risk factors profile, which are characteristic of the entire adult population of Ukraine, are preserved. The lower severity of familial hypercholesterolemia clinical manifestations in women according to the general Ukrainian familial hypercholesterolemia registry may be due to the predominance of heterozygous forms in the registry and inclusion of women of reproductive age against the background of preserved antiatherogenic effects of estrogen to the registry.
乌克兰家族性高胆固醇血症登记的临床和实验室特征的一般分析
目的是评估乌克兰家族性高胆固醇血症登记患者的临床和实验室特征,同时考虑到性别差异。材料和方法。231例家族性高胆固醇血症患者被纳入乌克兰家族性高胆固醇血症登记处:8名儿童(18岁以下)和223名成年患者(68名男性(30.5%),平均年龄43.4±1.3岁,155名女性(69.5%)- 45.5±1.0岁),根据DLCN标准确诊为家族性高胆固醇血症。进行一般临床、实验室、仪器检查和基因检测。结果和讨论。在动脉粥样硬化早期表现的家族性高胆固醇血症患者的一般登记中,男性家族性高胆固醇血症患者发生冠状动脉疾病、早发性冠状动脉疾病、脑及外周动脉粥样硬化、黄瘤、高甘油三酯血症、糖尿病、吸烟和心肌梗死史的可能性更大,导致DLCN评分更高(男性9.3分,女性7.8分,p< 0.05)。家族性高胆固醇血症的女性患者肥胖和高血压的比例较高,这与乌克兰人口研究的主要性别趋势相对应。自2017年以来,乌克兰首次启动了家族性高胆固醇血症患者的登记。2019年12月,最严重的形式——纯合子家族性高胆固醇血症——首次被乌克兰卫生部命令列入孤儿病清单。根据乌克兰家族性高胆固醇血症登记的数据分析,这种病理诊断相当晚,在乌克兰不充分。在家族性高胆固醇血症患者中,在动脉粥样硬化病变早期表现的背景下,心血管危险因素概况的性别特征(乌克兰整个成年人口的特征)得以保留。根据乌克兰家族性高胆固醇血症一般登记,女性家族性高胆固醇血症临床表现的严重程度较低,可能是由于登记中杂合子形式占主导地位,并纳入育龄妇女,背景是雌激素对登记的抗动脉粥样硬化作用。
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