Family History-Based Lipid Screening Misses Some Children

This method of cholesterol screening may miss children with dyslipidemias warranting treatment
By Beth Gilbert
HealthDay Reporter

MONDAY, July 12 (HealthDay News) -- Use of family history to determine which children need cholesterol screening -- instead of using universal cholesterol screening -- is likely to miss some children who have dyslipidemia, and fail to detect many who may have genetic dyslipidemias requiring pharmacologic treatment, according to a study published online July 12 in Pediatrics.

Susan K. Ritchie, R.N., of West Virginia University in Morgantown, and colleagues evaluated 20,266 fifth-grade children from the Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project who completed a family history and fasting lipid profile.

On the basis of positive family history, the researchers found that 71.4 percent of children met the National Cholesterol Education Program (NCEP) guidelines for cholesterol screening. Of those children, 1,204 (8.3 percent) were classified as having dyslipidemia (low-density lipoprotein ≥130 mg/dL), with 1.2 percent of these children with dyslipidemia possibly warranting pharmacologic treatment (low-density lipoprotein ≥160 mg/dL). In addition, of the 28.6 percent of children who did not meet NCEP guidelines for cholesterol screening on the basis of family history, 548 (9.5 percent) had dyslipidemia, with 1.7 percent of these children warranting pharmacologic treatment.

"Results indicate that the use of family history to determine the need for cholesterol screening in children would have (1) missed many with moderate dyslipidemia and (2) failed to detect a substantial number with likely genetic dyslipidemias that would require pharmacologic treatment," the authors write. "Universal cholesterol screening in the pediatric population will allow early diagnosis and appropriate treatment of children with significant dyslipidemia secondary to genetic and/or adverse lifestyle factors, hopefully preventing arterial disease."

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