Screening guidelines miss many children with hypercholesterolemia

Serena Gordon
Health Day Reporter

Monday, July 12 (HealthDay News)-Although promoted cholesterol Levels are generally considered an adult issue, and new studies are based on current screening guidelines. cholesterol Miss many kids who have higher in the kids Cholesterol level Than they should.

The study found that nearly 10% of children who did not meet current criteria for cholesterol screening already had elevated cholesterol levels.

“Our data retrospectively examined over 20,000 fifth-grade children screened over several years. 548 children who do not deserve screening under current guidelines have cholesterol abnormalities. I found out that I would consider using cholesterol-lowering drugs. ” Dr. William Neil, director of the Coronary Risk Detection (CARDIAC) project in the Appalachia community at the Robert C. Bird Health Sciences Center at West Virginia University, said.

“I think our data are pretty definitive that all children should be screened for cholesterol abnormalities,” he added.

The survey results will be published in the August issue. Pediatrics, But will appear online on July 12th. The researchers said there was no financial relationship associated with the report to be disclosed.

The current guidelines of the National Cholesterol Education Project recommend cholesterol screening for children with a history of premature babies or parents or grandparents. Heart disease -Before 55 years old-or those with significantly elevated cholesterol levels in their parents-total cholesterol is over 240 milligrams (mg / dL) per deciliter of blood. The NCEP guidelines also recommend screening children of unknown family history, especially those with other risk factors such as: obesity..

When these guidelines were developed, experts believed that about 25% of children in the United States would meet screening criteria. However, in a new study, 71.4% of children met the screening criteria.

Upon entering the study, experts knew that the guidelines could miss children with hypercholesterolemia, but there were concerns about labeling children with pre-existing conditions at such a young age. was. And there was concern that the drug might be over-prescribed to children. Studies have also raised concerns about the cost of universal screening.

The CARDIAC project was launched in 1998 as a way to identify children at risk of development. Coronary artery disease Through free screening at school. Since its inception, the study has screened 20,266 fifth graders from all over West Virginia.

From that group, 71.4% meet current screening guidelines and 8.3% (1,204 children) have abnormal blood fat levels containing low-density lipoprotein (LDL or “bad” cholesterol) levels above 130 mg / dL. Was found to have, and 1.2% were at levels above 160 mg / dL. Dosing may be considered when LDL levels reach 160 mg / dL and above, Neil said.

Of the remaining 28.6% of children who did not meet screening guidelines and were probably not at high risk of elevated cholesterol, 9.5% had abnormal blood fat levels, including: High cholesterol, And 1.7% were above the threshold for the likelihood of using cholesterol-lowering drugs, the study found.

Although West Virginia’s population is slightly higher than the national average, Neil said he believes these findings are likely to be similar in other parts of the country. He said that in children, genes play a greater role in cholesterol levels than lifestyle factors.

However, not everyone agrees that all children should be screened for cholesterol.

“I don’t believe in universal screening. I think it needs to be decided individually. Look at the child and his family history, lifestyle and risk factors,” said Preventive Cardiology at Pittsburgh Children’s Hospital. Dr. Eric Quivers, director, said. ..

And the quiver definitely has a family history High cholesterol, With sedentary behavior diet High-calorie, fatty foods can also affect children’s cholesterol and cardiovascular risk factors.

“Cholesterol levels have a genetic and environmental component,” says Quivers.

In addition, the most widely used cholesterol lowering DrugStatins -There are certain risks, such as the development of disorders that cause severe muscle damage and can be fatal in very rare cases. According to the National Cholesterol Education Project, the first line of defense against high cholesterol is lifestyle changes, including regular physical activity, even if the child meets the criteria for the potential of cholesterol-lowering drugs. diet Rich in fruits, vegetables and whole grains, you lose weight when needed.

However, the NCEP Expert Committee has stated that if a child with abnormally high cholesterol is at least 8 years old and has not achieved his or her treatment goals after at least 6 months according to a dietary plan designed to lower cholesterol. We are proposing to consider cholesterol drugs.

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Source: Dr. William Neil, Professor of Pediatrics, and Director of the Coronary Risk Detection (CARDIAC) Project in the Appalachian Community, Robert C. Bird Health Science Center, West Virginia University, Morgantown. Eric Quivers, MD, Dean of the Department of Preventive Cardiology, Pittsburgh Children’s Hospital. August 2010, Pediatrics

Screening guidelines miss many children with hypercholesterolemia

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