Zusammenfassung
Das Behandlungsziel bei Kindern und Jugendlichen mit primär genetischen Hyperlipoproteinämien ist die Langzeitprävention sekundärer Organschäden mit geringstmöglichem Nebenwirkungsrisiko. Dabei ist für die große Mehrzahl der Patienten eine konsequente Modifikation der Ernährung die grundlegende und wichtigste Therapiemaßnahme [25, 29]. Medikamentöse Lipidsenker werden bei pädiatrischen Patienten zurückhaltend und nur bei strenger Indikation eingesetzt, ihre Anwendung erfolgt stets ergänzend zu einer Diättherapie [27, 30, 50]. In diesem Beitrag werden ernährungstherapeutische Aspekte der im Kindesalter praktisch wichtigen schweren Hyperlipoproteinämieformen diskutiert.
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Literatur
Ahrens EH, Hirsch J, Insull W, Tsaltas TT, Blomstrand R, Peterson ML (1957) The influence of dietary fats on serum-lipid levels in man. Lancet 1: 943–953
Anderson JW, Story L, Sieling B, Chen WJ, Petro MS, Story J (1984) Hypocholesterolemic effects of oat-bran or bean intake for hypercholesterolemic men. Am J Clin Nutr 40: 1146–1155
Berry EM, Eisenberg S, Haratz D, Friedlander Y, Norman Y, Kaufmann NA, Stein Y (1991) Effects of diets rich in monounsaturated fatty acids on plasma lipoproteins - the Jerusalem nutrition study: high MUFAs vs high PUFAs. Am J Clin Nutr 53: 899–907
Bonanome A, Grundy SM (1988) Effect of dietary stearic acid on plasma cholesterol and lipoprotein levels. N Engl J Med 318: 1244–1248
Brunzell JD (1989) Familial lipoprotein lipase deficiency and other causes of the chylomicronemia syndrome. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The metabolic basis of inherited disease. McGraw-Hill, New York, pp 1165–1180
Buring JE, Gaziano JM, Manson JE, Hennekens CH (1993) Current and future epidemiologic perspectives on cardiovascular disease. In: Gotto AM, Mancini M, Schwandt P (eds) Treatment of severe dyslipoproteinemia in the prevention of coronary heart disease. Karger, Basel (im Druck)
Connor WE, Hodges RE, Bleiler RE (1961) The serum lipids in men receiving high cholesterol and cholesterol-free diets. J Clin Invest 40: 894–901
Deckelbaum RJ (1990) Nutrition, the child and atherosclerosis. Acta Paediatr Scand [Suppl] 365: 7–12
Durrington PN (1993) Hyperlipidemia. Diagnosis and management. Wright, London, pp 1–308
Esterbauer H, Dieber-Rotheneder M, Waeg G, Striegl G, Jürgens G (1990) Biochemical, structural and functional properties of oxidized low-density lipoprotein. Chem Res Toxicol 279: 402–405
The Expert Panel Report of the National Cholesterol Education Program (1988) Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults. Arch Int Med 148: 36–69
Ginsberg HN, Barr SL, Gilbert A, Karmally W, Deckelbaum R, Kaplan K, Ramakrishan R, Holleran S, Dell RB (1990) Reduction of plasma cholesterol level in normal men on an American Heart Association step 1 diet or a step i diet with added monounsaturated fat. N Engl J Med 322: 574–579
Goldstein JL, Brown MS (1989) Familial hypercholesterolemia. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The metabolic basis of inherited disease. McGraw-Hill, New York, pp 1215–1250
Grande F, Anderson JT, Keys A (1970) Comparison of effects of palmitic and stearic acids in the diet on serum cholesterol in man. Am J Clin Nutr 23: 1184–1193
Grundy SM, Vega GL (1988) Plasma cholesterol responsiveness to saturated fatty acids. Am J Clin Nutr 47: 822–824
Grundy SM, Menke MA (1990 a) Dietary influences on serum lipids and lipoproteins. J Lipid Res 31: 1149–1172
Grundy SM, Menke MA (1990b) Dietary influences on serum lipids and lipoproteins. J Lipid Res 31: 1149–1172
Harris WS (1989) Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review. J Lipid Res 30: 785–807
Hayes KC, Pronczuk A, Diersen-Schade D (1991) Dietary saturated fatty acids (12:0, 14:0, 16:0) differ in their impact on plasma cholesterol and lipoproteins in nonhuman primates. Am J Clin Nutr 53: 491–498
Hegsted DM, McGandy RB, Myers ML, Stare FJ (1965) Quantitative effects of dietary fat on serum cholesterol in man. Am J Clin Nutr 17: 281–295
Horlick L, Craig BM (1957) Effect of long-chain polyunsaturated and saturated fatty acids on the serum lipids of man. Lancet 11: 566–569
Jackson RL, Kashyap ML, Barnhart RL, Allen C, Hogg E, Glueck CJ (1984) Influence of polyunsaturated and saturated fats on plasma lipids and lipoproteins in man. Am J Clin Nutr 39: 589–597
Jialal I, Grundy SM (1992) Effect of dietary supplementation with alpha-tocopherol on the oxidative modification of low density lipoprotein. J Lipid Res 33: 899–906
Keys A, Anderson JT, Grande F (1965) Serum cholesterol response to changes in the diet. Metabolism 14: 776–787
Koletzko B (1990) Störungen des Fettstoffwechsels. In: Reinhardt D, von Harnack GA (Hrsg) Therapie der Krankheiten des Kindesalters. Springer, Berlin Heidelberg New York Tokyo, S 104–110
Koletzko B (1991) Zufuhr, Stoffwechsel und biologische Wirkungen transisomerer Fettsäuren bei Säuglingen. Nahrung - Food 35: 229–283
Koletzko B (1993) Behandlung von Fettstoffwechselstörungen im Kindesalter. Pädiatr Praxis (im Druck)
Koletzko B. Screening auf Hypercholesterinämie im Kindesalter. Pädiatrische Praxis (im Druck)
Koletzko B, Kupke I, Wendel U (1992) Treatment of hypercholesterolemia in children and adolescents. Acta Paediatr 81: 682–685
Koletzko B, Kupke I, Wendel U (1992) Efficacy of treatment in children and adolescents with inherited hypercholesterolemia. In: Gotto AM, Mancini M, Schwandt P (eds) Treatment of severe dyslipoproteinemia in the prevention of coronary heart disease. Karger, Basel, p 299–304
Kovanen PT, Brown MS, Basu SK, Bilheimer DW, Goldstein JL (1981) Saturation and suppression of hepatic lipoprotein receptors: a mechanism for the hypercholesterolemia of cholesterol-fed rabbits. Proc Natl Acad Sei USA 78: 1396–1400
Kromhout D, Bosschieter EB, de Lezenne Coulander C (1985) The inverse relation between fish consumption and 20-year mortality from coronary heart disease. N Engl J Med 312: 1205–1209
Laurin D, Jacques H, Moorjani S, Steinke FH, Gagne C, Brun D, Lupien P-J (1991) Effects of a soy-protein beverage on plasma lipoproteins in children with familial hypercholesterolemia. Am J Clin Nutr 54: 98–103
Leadbetter J, Ball MJ, Mann JI (1991) Effects of increasing quantities of oat brain in hypercholesterolemic people. Am J Clin Nutr 54: 841–842
Lipid Research Clinics Program (1984) The Lipid Research Clinics coronary prevention trial results: II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. J Am Med Assoc 251: 365–373
Mattson FH, Grundy SM (1985) Comparison of effects of dietary saturated, monounsaturated, and polyunsaturated fatty acids on plasma lipids and lipoproteins in man. J Lipid Res 26: 194–202
Mensink RP, Katan MB (1989) Effect of a diet enriched with monounsaturated or polyunsaturated fatty acids on levels of low density and high density lipoprotein cholesterol in healthy man and women. N Engl J Med 321: 436–441
Mensink RP, Katan MB (1990) Effect of dietary trans fatty acids on high-density and low-density lipoprotein cholesterol levels in healthy subjects. N Eng J Med 323: 439–445
Newman WP, Freedman DS, Yoors AW, Gard PD, Srinivasan SR, Cresanta JL, Williamson GD, Webber LS, Berenson GS (1986) Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis. N Engl J Med 314: 138–144
Nicolosi RJ, Stucchi AF, Kowala MC, Henessy LK, Hegsted DM, Schaefer EJ (1990) Effect of dietary fat saturation and cholesterol on LDL composition and metabolism. Arteriosclerosis 10: 119–128
Princen HMG, van Poppel G, Vogelezang C, Buytenhek R, Kok FJ (1992) Supplementation with vitamin E but nor beta-carotene in vivo protects low density lipoprotein from lipid peroxidation in vitro. Effect of cigarette smoking. Arterioscler Thromb 212: 554–562
Riemersma RA, Wood DA, Macintyre CCA, Elton RA, Gey KF, Oliver MF (1991) Risk of angina pectoris and plasma concentrations of vitamin A, C and E and carotene. Lancet 337: 1–5
Schacky C (1987) Prophylaxis of atherosclerosis with marine omega-3 fatty acids. Ann Intern Med 107: 890–899
Shepherd JC, Packard CJ, Grundy SM, Yeshurun D, Gotto AM jr, Taunton OD (1980) Effects of saturated and polyunsaturated fat diets on the chemical composition and metabolism of low density lipoproteins in man. J Lipid Res 21: 91–99
Sirtori CR, Agradi E, Conti F, Mantero O, Gatti E (1977) Soybean-protein diet in the treatment of type-II hyperlipoproteinaemia. Lancet 1: 275–277
Slack J (1969) Risks of ischaemic heart disease in familial hyperlipoproteinaemic states. Lancet 11: 1380–1382
Souci SW, Fachmann W, Kraut H (1989) Die Zusammensetzung der Lebensmittel. Nährwert Tabellen 1989/90, 4. Aufl. Wissenschaftliche Verlagsgesell¬schaft, Stuttgart, S 1–1028
Spady DK, Dietschy JM (1985) Dietary saturated triacylglycerols suppress hepatic low density lipoprotein receptors in the hamster. Proc Natl Acad Sei USA 82: 4526–4530
Stary HC (1989) Evolution and progression of atherosclerotic lesions in coronary arteries of children and young adults. Arteriosclerosis 9 [Suppl 1]:I-19–I - 32
Stein EA (1989) Treatment of familial hypercholesterolemia with drugs in children. Arteriosclerosis [Suppl 1]: 145–151
Strong JP, McGill HC (1967) Diet and experimental atherosclerosis in ba-boons. Am J Pathol 50: 669–690
Study Group European Atherosclerosis Society (1987) Strategies for the prevention of coronary heart disease: a policy statement of the European Atherosclerosis Society. Eur Heart J 8: 77–88
Troisi R, Willett WC, Weiss ST (1992) Trans-fatty acid intake in relation to serum lipid concentrations in adult men. Am J Clin Nutr 56: 1019–1024
Weisweiler P, Janetschek P, Schwandt P (1985) Influence of polyunsaturated fats and fat restriction on serum lipoproteins in humans. Metabolism 34: 83–87
West RJ, Lloyd JK, Leonard JV (1980) Long term follow-up of children with familial hypercholesterolemia treated with cholestyramine. Lancet 11: 873–875
Widhalm K (1987) Pediatric guidelines for lipid reduction. Eur Heart J 8 [Suppl E]: 65–70
Wynder EL, Berenson GS, Strong WB, Williams C (1989) Coronary artery disease prevention: cholesterol, a pediatric perspective. An American Health Foundation Monograph. Prev Med 18: 323–409
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Koletzko, B. (1993). Primär genetische Hyperlipoproteinämien im Kindesalter. In: Koletzko, B. (eds) Ernährung chronisch kranker Kinder und Jugendlicher. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78146-9_20
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DOI: https://doi.org/10.1007/978-3-642-78146-9_20
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