Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting 6–18% of adolescents and is strongly associated with obesity and cardiovascular risk factors, enhancing the risk of atherosclerosis. Thirty-two adolescents with newly diagnosed PCOS were evaluated for lipid profile disorders, insulin resistance, inflammation, non-alcoholic fatty liver disease (NAFLD), and subclinical atherosclerosis through measurements of carotid intima–media thickness (cIMT). The relationships of the above markers with increased body mass index and abdominal obesity were investigated. Twenty-three adolescents (72%) were overweight (OW) or obese (OB). The OW/OB group had significantly higher insulin, HOMA-IR, high-sensitive C-reactive protein (hsCRP), visceral adiposity index (VAI), and lipid accumulation product (LAP) levels; and lower glucose-per-insulin ratios and HDL-C levels compared to the healthy weight group. The cIMT and small dense low-density lipoprotein cholesterol (sdLDL-C) levels did not differ between the two groups. Similarly, cIMT and sdLDL-C levels did not differ between PCOS-adolescents and healthy controls. CIMT was positively correlated with systolic blood pressure and waist circumference per height ratio. In conclusion, OW/OB PCOS-adolescents have a cluster of adverse factors predisposing them to atherosclerotic cardiovascular disease. Therefore, early cardiovascular risk assessment, as well as timely and targeted interventions, are necessary for prevention.

The aim of the present study was to evaluate the efficacy and safety of the long-term use of a dietary supplement containing red yeast rice (RYR), combined with other natural compounds, in children and adolescents with primary hypercholesterolemia. A nutraceutical, containing RYR, policosanols, coenzyme Q10, astaxanthin and folic acid (commercial name: Armolipid), was administered once daily in 84 children/adolescents with moderate or severe primary hypercholesterolemia. Moreover, 19 of the participants consumed 1.5–2.5 g of phytosterols daily until the initiation of dietary supplementation with Armolipid. Clinical and laboratory evaluation took place before and 6 and 16 months after treatment. Nutraceutical consumption resulted in a significant decrease in total cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and apolipoprotein B levels, which was maintained with long-term administration (p < 0.001). No changes were observed in high-density lipoprotein cholesterol, triglycerides, apolipoprotein A1 and lipoprotein (a) levels. In children previously on phytosterol supplementation, Armolipid use exerted a further significant reduction in atherogenic lipoproteins. Armolipid may be an effective and safe complementary treatment for children with moderate and severe hypercholesterolemia. More prospective studies on larger cohorts are needed to establish the role of nutraceuticals containing RYR, policosanols and other natural compounds in the treatment of children with hypercholesterolemia.

Pediatric chronic kidney disease (CKD) patients, as well as kidney transplant patients, are at an increased risk of developing cardiovascular disease. BNP measurement, as a biomarker of cardiovascular risk, has been recommended to this high-risk population. Plasma BNP levels were measured in 56 CKD children in either pre-dialysis stage, hemodialysis (HD) or renal transplant recipients (RTRs) and in 76 sex- and age-matched healthy controls. BNP levels were investigated in HD children, before and after the completion of their HD session. BNP levels in total CKD population, in pre-dialysis stage patients and on HD were significantly higher, compared to the respective controls. HD children had higher BNP levels compared to CKD patients in the pre-dialysis stage. Moreover, post-HD BNP concentration was slightly higher than pre-HD, with the difference being marginally statistically significant. BNP was positively correlated with eGFR, creatinine, cystatin-C and parathormone and negatively with albumin and 25-hydroxyvitamin D. A positive correlation between BNP concentration and the ratio of E/A in pulse-wave Doppler echocardiography was also observed. In conclusion, CKD pediatric patients, mainly those undergoing HD, have high plasma BNP levels which do not decrease after the HD session. This is indicative of a greater risk for future cardiovascular disease.

The aim of the present study was to evaluate the efficacy and safety of the long-term use of a dietary supplement containing red yeast rice (RYR), combined with other natural compounds, in children and adolescents with primary hypercholesterolemia. A nutraceutical, containing RYR, polycosanols, coenzyme Q10, astaxanthin and folic acid (commercial name: Armolipid), was administered once-daily in 84 children/adolescents with moderate or severe primary hypercholesterolemia. Moreover, 19 of the participants consumed 1.5-2.5g of phytosterols daily until the initiation of dietary supplementation with Armolipid. Clinical and laboratory evaluation took place before and 6 and 16 months after treatment. Nutraceutical consumption resulted in a significant decrease in total cholesterol, low density lipoprotein - cholesterol, non-high density lipoprotein – cholesterol and apolipoprotein B levels, that remained at the long-term administration (p