Pediatric lipid reference values in the general population: The Dutch lifelines cohort study

Area of Science:

• Pediatric cardiology
• Clinical lipidology
• Public health

Background:

• Atherosclerosis begins in childhood, influenced by lifelong low-density lipoprotein cholesterol (LDL-c) exposure.
• Early identification of severely elevated LDL-c in children is critical, particularly for familial hypercholesterolemia (FH).
• Understanding pediatric lipid level distribution is essential for identifying children at risk.

Purpose of the Study:

• To establish contemporary, age- and gender-specific pediatric reference values for lipid and lipoprotein levels.
• To assist healthcare professionals in identifying dyslipidemia and FH in children.
• To provide data supporting early intervention for cardiovascular risk.

Main Methods:

• Utilized data from the large, prospective, population-based Lifelines cohort study in the Netherlands.
• Included 8071 children aged 8–18 years with measured fasting lipid levels.
• Generated smoothed reference curves and percentiles using Generalized Additive Models in R.

Main Results:

• Observed significant age-related and gender-specific changes in lipid and lipoprotein levels.
• Identified a high and unexpected prevalence of severely elevated LDL-c (>190 mg/dL) in both boys and girls.
• Data from 8071 children (3823 boys, 4248 girls) were analyzed.

Conclusions:

• The study provides contemporary plasma lipid reference ranges for children.
• These ranges can aid physicians in identifying children at risk for premature atherosclerosis, including FH.
• Highlights the need for early screening and management of dyslipidemia in pediatric populations.