Patients with familial hypercholesterolemia (FH) are at risk of cardiovascular disease due to cumulative exposure to high LDL-C values. To date, no effective screening test has been found to detect FH. In a study whose findings were published in the journal ‘Journal of Clinical Lipidology’, the aim of the researchers was to evaluate the applicability of a screening test for FH done by directly measuring the LDL-C values in preschool children.
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The researchers measured the LDL-C values using capillary blood sampling during the routine mandatory examinations in children aged 2 to 6. In addition, the researchers collected information on the patients’ family history, such as the occurrence of dyslipidemia and/or early cardiovascular disease in first or second degree relatives.
A total of 15,009 children participated in the study (52.2% boys, median age 3.9 years [טווח בין רבעוני 3.0-5.1]). A positive family history of hyperlipidemia was found in 40.9% of the cases, while in 12.0% it was also found in at least one first-degree relative. It was also found that in the total cohort, the median value of LDL-C was 93 milligrams/deciliter [טווח בין רבעוני 79-109 מיליגרם/דציליטר]. Boys were found to have higher levels of LDL-C compared to girls (p<0.0001). No difference was found related to the age of the patients (p=0.757). Children from families with a history of hypercholesterolemia/dyslipidemia were found to have significantly higher levels of LDL-CJ(p<0.001) והם נטו יותר להיות בקבוצות עם ערכי LDL-C מעל 135 מיליגרם/דציליטר (3.5 מילימול/ליטר, אחוזון 96; 53.2% לעומת 40.3%, p < 0.001), ומעל 160 מיליגרם/דציליטר (4.1 מילימול/ליטר, אחוזון 99; 45.3% לעומת 40.7%, p < 0.001) בהשוואה לילדים ללא היסטוריה משפחתית.
In conclusion, direct measurement of LDL-C levels in children aged 2-6 years is applicable, and has the ability to provide reliable information for screening for hypercholesterolemia. The measurement can be performed as part of the required routine tests as well as at any voluntary visit to the pediatricians. The LDL-C values can be used for screening tests for FH in the general population.
source:
Kordonouri O, Arens S, Lange K, Christoph J, Marquardt E, Danne TPA. Direct LDL-C estimation in preschoolers: Practicable first step for FH screening. J Clin Lipidol. 2023 Feb 22:S1933-2874(23)00034-X. doi: 10.1016/j.jacl.2023.02.004. Epub ahead of print. PMID: 36858936.