Infect Chemother.  2017 Mar;49(1):44-50. 10.3947/ic.2017.49.1.44.

Evaluation of Lipid Profile Changes in Pediatric Patients with Acute Mononucleosis

• Sayyahfar
• Lavasani A
• Nateghian
• Karimi A

• KMID: 2375098
• DOI: http://doi.org/10.3947/ic.2017.49.1.44

Abstract

BACKGROUND
Acute Epstein-Barr virus (EBV) infection could lead to atherogenic lipid profile changes in adults; while there is no evidence about the children with Infectious mononucleosis (IM). The aim of this study was to evaluate the lipid profile of the children in acute phase of mononucleosis and two months after the recovery.
MATERIALS AND METHODS
From 2010 through 2012, 36 children with IM aged 1-10 years were enrolled in a prospective cross-sectional study. Fasting serum total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), and triglyceride level were measured during acute phase of the disease and after 2 months of the recovery.
RESULTS
From 36 patients enrolled, 25 (69.4%) cases were male and the mean age of the patients was 4.1 ± 2.0 years. The mean of the total cholesterol level in the acute phase and 2 months after the recovery were149.5 ± 35.3 mg/dL and 145.7±30.6, respectively (P = 0.38). However, the serum level of HDL cholesterol in patients after 2 months of recovery was significantly increased (37.9 ± 9.3 mg/dL vs. 28.5 ± 10.6 mg/dL, P <0.001). The mean value of serum LDL cholesterol was significantly reduced, two months after recovery (81.4 ± 19.5 mg/dL, vs. 92.6 ± 28.8 mg/dL, P = 0.009). Furthermore, the serum triglyceride level was significantly reduced after the recovery (108.7 ± 36.9 mg/dL) compared with the acute phase (163.8 ± 114.3 mg/dL) (P = 0.004).
CONCLUSION
EBV infection in children could change lipid profile which is partially restored 2 months after the recovery.

Keyword

Atherogenic changes; Epstein–Barr virus; Infectious mononucleosis; Lipid profile; Pediatrics

MeSH Terms

Adult
Child
Cholesterol
Cholesterol, HDL
Cholesterol, LDL
Cross-Sectional Studies
Epstein-Barr Virus Infections
Fasting
Herpesvirus 4, Human
Humans
Infectious Mononucleosis
Lipoproteins
Male
Pediatrics
Prospective Studies
Triglycerides
Cholesterol
Cholesterol, HDL
Cholesterol, LDL
Lipoproteins

Figure

• 

  Figure 1 Distribution (mean and 95% confidence interval) of lipid profile in children with Epstein–Barr virus infection and relative atherogenesis risk categories in acute phase and two months after the recovery. TG, triglyceride; HDL, high-density lipoprotein; LDL; low-density lipoprotein; mo, month.

• 

  Figure 2 Correlation of lipid profile changes after two months of the recovery with acute phase values in patients with Epstein–Barr virus infection. (More negative changes for higher values of cholesterol, TG and LDL and more positive changes for lower values of HDL). TG, triglyceride; LDL, low-density lipoprotein; HDL, high-density lipoprotein .

Reference

1. Kazar J, Mongiellova V, Gajdos M, Kovacova E, Tomka J, Slysko R, Fridrich V. Anti-cytomegalovirus antibodies and other atherosclerosis risk factors in patients with cardiovascular diseases. J Geriatr Cardiol. 2007; 4:131–134.

2. Memon RA, Staprans I, Noor M, Holleran WM, Uchida Y, Moser AH, Feingold KR, Grunfeld C. Infection and inflammation induce LDL oxidation in vivo. Arterioscler Thromb Vasc Biol. 2000; 20:1536–1542.

3. O'Connor S, Taylor C, Campbell LA, Epstein S, Libby P. Potential infectious etiologies of atherosclerosis: a multifactorial perspective. Emerg Infect Dis. 2001; 7:780–788.

4. Kanbay M, Gür G, Yücel M, Yilmaz U, Boyacioğlu S. Does eradication of Helicobacter pylori infection help normalize serum lipid and CRP levels? Dig Dis Sci. 2005; 50:1228–1231.

5. Khovidhunkit W, Kim MS, Memon RA, Shigenaga JK, Moser AH, Feingold KR, Grunfeld C. Effects of infection and inflammation on lipid and lipoprotein metabolism: mechanisms and consequences to the host. J Lipid Res. 2004; 45:1169–1196.

6. Van Lenten BJ, Reddy ST, Navab M, Fogelman AM. Understanding changes in high density lipoproteins during the acute phase response. Arterioscler Thromb Vasc Biol. 2006; 26:1687–1688.

7. Nassaji M, Ghorbani R. Plasma lipid levels in patients with acute bacterial infections. Turk J Med Sci. 2012; 42:465–469.

8. Khovidhunkit W, Memon RA, Feingold KR, Grunfeld C. Infection and inflammation-induced proatherogenic changes of lipoproteins. J Infect Dis. 2000; 181:Suppl 3. S462–S472.

9. Apostolou F, Gazi IF, Logas K, Tellis CC, Tselepis AD, Liberopoulos EN, Elisaf M. Acute infection with Epstein–Barr virus is associated with atherogenic lipid changes. Atherosclerosis. 2010; 212:607–613.

10. Macsween KF, Crawford DH. Epstein-Barr virus-recent advances. Lancet Infect Dis. 2003; 3:131–140.

11. Azizi F, Rahmani M, Madjid M, Allahverdian S, Ghanbili J, Ghanbarian A, Hajipour R. Serum lipid levels in an Iranian population of children and adolescents: Tehran lipid and glucose study. Eur J Epidemiol. 2001; 17:281–288.

12. Anonymous . National Cholesterol Education Program: highlights of the repot of the expert panel on blood cholesterol levels in children and adolescents. US Department of health and human services, public health service. National institute of health, national heart, lung, and blood institute. J Am Osteopath Assoc. 1992; 92:380–388.

13. Tershakovec AM, Daniel J. Disorders of lipoprotein metabolism and transport. In : Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia, PA: Saunders;2004. p. 445–459.

14. Khosla SN, Goyle N, Seth RK. Lipid profile in enteric fever. J Assoc Physicians India. 1991; 39:260–262.

15. Alvarez C, Ramos A. Lipids, lipoproteins and apoproteins in serum during infections. Clin Chem. 1986; 32:142–145.

16. Burger D, Dayer JM. High-density lipoprotein-associated apolipoprotein A-I: the missing link between infection and chronic inflammation? Autoimmun Rev. 2002; 1:111–117.

17. Gazi IF, Elisaf MS. Effect of infection on lipid profile: focus on Epstein–Barr virus. Clin Lipidol. 2010; 5:607–610.

18. Volanen I, Raitakari OT, Vainionpää R, Arffman M, Aarnisalo J, Anglé S, Kallio K, Simell O. Serum lipid profiles poorly correlate with Chlamydia pneumoniae, Helicobacter pylori, and cytomegalovirus seropositivity in prospectively followed-up healthy children. Arterioscler Thromb Vasc Biol. 2005; 25:827–832.

19. Işcan A, Yiğitoğlu R, Onağ A, Vurgun N, Ari Z, Ertan P, Sengil AZ. Should children with infection be tested for lipid, lipoprotein and apolipoprotein? Acta Paediatr Jpn. 1998; 40:47–51.

20. Leach CT, Sumaya CV, Harrison GJ. Epstein-Barr Virus. In : Cherry J, Demmler-Harrison G, Kaplan S, Steinbach W, Hotez P, editors. Feigin and Cherry's textbook of pediatric infectious diseases. 7th ed. Philadelphia, PA: Elsevier Press;2014. p. 1992–2015.