title: Hypercholesterolemia--a disease with expression from childhood.
abstract: BACKGROUND
  Hypercholesterolemia results from an alteration, genetic or acquired, in lipoprotein metabolism. Evidence that hypercholesterolemia is associated with the atherosclerotic process from childhood justifies the screening of high-risk children and initiation of therapy at preschool ages.
  
  
  OBJECTIVE
  To assess children referred for pediatric consultations due to hypercholesterolemia.
  
  
  METHODS
  Children and adolescents referred for pediatric consultations with a diagnosis of hypercholesterolemia were enrolled. Information on family history and clinical, anthropometric and biochemical parameters was recorded and, when appropriate, molecular study was performed.
  
  
  RESULTS
  A total of 168 children were assessed. Forty-six presented a familial hypercholesterolemia phenotype and in 22 of these, a mutation in the low-density lipoprotein (LDL) receptor gene was identified. The lipid profile of the group with mutations showed significantly higher values of total and non-high-density lipoprotein (HDL) cholesterol compared to the group without mutations (total cholesterol 316.5±75.9 mg/dl vs. 260.9±42,0 mg/dl; non-HDL cholesterol 268.3±72.6 mg/dl vs. 203.5±43.9 mg/dl; p<0.05). Of the total, 55 were prescribed pharmacological therapy and the others underwent diet and exercise interventions only. A greater reduction in LDL cholesterol was observed in individuals under pharmacological therapy compared to those prescribed diet and exercise only (30.3% vs. 18.1%). Drug side effects were insignificant.
  
  
  CONCLUSIONS
  It is possible to maintain a normal lipid profile in most individuals with familial hypercholesterolemia in order to reduce the risk of early onset of atherosclerosis, which is associated with serious cardiovascular complications from childhood.
authors.affiliation: Unidade de Nutrição, Serviço de Pediatria, Centro Hospitalar São João, Porto, Portugal. ceuespinheira@gmail.com
authors.forename: Maria do Céu
authors.initials: Mdo C
authors.lastname: Espinheira
authors.forename: Carla
authors.initials: C
authors.lastname: Vasconcelos
authors.forename: Ana Margarida
authors.initials: AM
authors.lastname: Medeiros
authors.forename: Ana Catarina
authors.initials: AC
authors.lastname: Alves
authors.forename: Mafalda
authors.initials: M
authors.lastname: Bourbon
authors.forename: António
authors.initials: A
authors.lastname: Guerra
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000175:diagnosis*; D006938:Hyperlipoproteinemia Type II / Q000175:diagnosis; D008297:Male