title: Identification and management of dyslipidemic children.
abstract: Atherosclerotic cardiovascular disease is a leading cause of morbidity and premature mortality in Western countries and dyslipidemia is a recognized major cardiovascular risk factor. Evidences demonstrate that the atherosclerotic process begins early in childhood. Children showing dyslipidemia, as well as other cardiovascular risk factors, including hypertension, overweight/obesity and diabetes mellitus, are defined at high risk. To identify these children a selective screening between 2 to 10 years of age is necessary. This program must be performed to those children showing a familiarity for primary dyslipidemia and/or precocious cardiovascular events. These subjects need to undergo lipid biochemical analysis and assessment of other emergent risk factors (as ApoB, ApoA-I and their ratio). Given that total cholesterol and low-density lipoprotein cholesterol (LDL-C) concentrations vary by age and sex, the use of percentile values according to these parameters is now recommended. In these high-risk subjects the first step to lower LDL-C under the value of 130 mg/dL is represented by an appropriate physical activities and Step II diet. This entails further reduction of saturated fatty acid intake to less than 7% of daily calories and of cholesterol to less than 200 mg/day (since two years of age). When diet therapy is insufficient to lower LDL-C to the acceptable concentration, the use of non-pharmacologic agents (soluble fibers, plant stanols, sterols) is suggested. The third approach, for children showing persistent elevated LDL-C >95(th) percentile, is represented by drugs, that are allowed only in children older than eight years.
authors.affiliation: Department of Pediatrics, University of Turin, Turin, Italy. ornella.guardamagna@unito.it
authors.forename: O
authors.initials: O
authors.lastname: Guardamagna
authors.forename: V
authors.initials: V
authors.lastname: Baracco
authors.forename: F
authors.initials: F
authors.lastname: Abello
authors.forename: G
authors.initials: G
authors.lastname: Bona
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology; D002648:Child; D050171:Dyslipidemias / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D012307:Risk Factors