Avaliação de marcadores bioquímicos, inflamatórios e hemostáticos em pacientes portadores de hipercolesterolemia familiar: correlação com terapia farmacológica

Abstract

Familial Hypercholesterolemia (FH) is a genetic disorder from an autosomal dominant inheritance, being, however, a kind of disease sub-diagnosed and mistreated. This paper aim to assess the parameters of lipid profile, inflammatory and homeostasis with individuals suffering from FH by comparing patients treated (statin + ezetimibe) and those who were no treated though. For this study FH index-cases were selected from patients who were seen by physician at the ambulatory of Endocrinology City-hall of Bom Despacho City, with a clinical diagnostic, probable and possible by Simon Broome & Dutch MEDPED. In addition, a familiar screening cascade was performed for value of cholesterol present in the lipoprotein of low molecular weight (LDLc) > 190mg/dL in adults and > 160 mg/dL in children. This study included 80 males and females individuals from 03 to 85 years old, distributed into two treated groups (T=53) and not-treated (NT=27). The lipid profile, total cholesterol (TC), cholesterol present in the lipoprotein of high molecular weight (HDLc) and triglycerides (TG), which was determined by enzimatic colorimetric method and, LDLc by Friedwald equation, the protein C reactive ultrasensitive (PCRus) by rapid quantitative test, the proprotein convertase subtilisina/kexina 9 (PCSK9) by ELISA, and the thrombin generation test (TG) by Calibrated Automated Thrombogram method (CAT). Estatistic analyses were performed by Minitab program version 2017. Significant differences were observed concerned to the treatment and gender towards the lipid profile, the women in the group not-treated have shown high levels of TC, LDLc and non-HDL and, for those women who were treated, higher levels of HDLc and TG contrary to the men. By considering hormonal therapy treatment, the women have presented increase significant homeostasis parameters and PCRus related those women who were not taken hormonal therapy. By comparing age group, elderly individuals have presented more hypercoagulated and presenting a higher significant values towards TG and PCSK9. PCSK9 has correlated positively towards the lipid profile parameters and homeostasis in the groups T as well as NT. In summary, the use of this combined therapy has shown a superiority reduction of lipid profile and homeostasis.