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Pediatric Cholesterol Screening Needs to Be Universal

By Labmedica International staff writers
Posted on 14 Apr 2014
Image: Cytology of pericardial fluid showing abundant, rectangular crystals corresponding to cholesterol crystals and inflammatory cells consisting of lymphocytes and macrophages (Photo courtesy of Dr. Mercedes Camprubí).
Image: Cytology of pericardial fluid showing abundant, rectangular crystals corresponding to cholesterol crystals and inflammatory cells consisting of lymphocytes and macrophages (Photo courtesy of Dr. Mercedes Camprubí).
Approximately one out of three children screened for high cholesterol between the ages of 9 and 11 had borderline or high cholesterol, potentially placing them at greater risk for future cardiovascular disease.

While cardiovascular disease in children is rare, the presence of certain risk factors in childhood can increase the chances of developing heart disease as an adult and previous studies have demonstrated that atherosclerosis can begin in childhood.

Scientists at Texas Children's Hospital (Houston, TX, USA) examined the medical records of 12,712 children who had been screened for cholesterol levels as part of the largest studies of outpatient pediatric clinic visits. Of these, 4,709, or 30% had borderline or elevated total cholesterol.

In the study, the investigators found that boys were more likely than girls to have elevated total cholesterol, low-density lipoprotein (LDL), and triglycerides, while girls had lower high-density lipoprotein (HDL). Obese children were more likely to have elevated total cholesterol, LDL and triglycerides, with lower HDL in comparison to non-obese children. Mean total cholesterol, LDL, non-HDL, and HDL were all within the normal range, 162 mg/dL, 92 mg/dL, 113 mg/dL and 52 mg/dL, respectively and mean triglycerides were borderline or abnormal at 103 mg/dL.

A potential study limitation is that it is unknown if testing was ordered in a universal manner or selectively based upon individual risk factors or a family history of premature cardiac disease. Thomas Seery, MD, pediatric cardiologist at Texas Children's Hospital, assistant professor of Pediatrics at Baylor College of Medicine, said, “Children need to have their cholesterol panel checked at some point during this timeframe of 9 to 11 years old. In doing so, it presents the perfect opportunity for clinicians and parents to discuss the importance of healthy lifestyle choices on cardiovascular health. Our findings give a compelling reason to screen all children’s blood cholesterol.”

The American Academy of Pediatrics (Elk Grove Village, IL, USA) calls for universal cholesterol screening of children between the ages of 9 and 11 years and, again between 17 and 21 years of age. The study was presented the American College of Cardiology's 63rd Annual Scientific Session held March 29–31, 2014, in Washington DC (USA).

Texas Children's Hospital
American Academy of Pediatrics

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