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[Diagnosis, clinical features and treatment of hyperlipidemias in children]
Insights
Early diagnosis and treatment of hyperlipidemias in children are crucial for preventing premature atherosclerotic disease and ischemic cardiovascular disease. Dietary management is recommended for polygenic forms, while familial hypercholesterolemias may require drug interventions like cholestyramine.
Area of Science:
- Cardiovascular Medicine
- Pediatric Endocrinology
- Metabolic Disorders
Context:
- Hyperlipidemias are significant risk factors for premature atherosclerotic disease.
- Ischemic cardiovascular disease accounts for 50% of deaths in Western Europe.
- Early detection and intervention are vital for cardiovascular disease prevention.
Purpose:
- To provide an overview of lipoprotein composition and metabolism.
- To outline classification, laboratory diagnosis, and treatment of pediatric hyperlipidemias.
- To discuss therapeutic strategies and future drug development for hyperlipidemias.
Summary:
- Reviews lipoprotein metabolism and classification of hyperlipidemias in children.
- Highlights dietary treatment for polygenic/combined familial hyperlipidemias.
- Recommends cholestyramine for familial hypercholesterolemias, discussing potential LDL-receptor enhancing drugs.
Impact:
- Emphasizes the need for early screening in families with a history of premature heart disease or hypercholesterolemia.
- Informs clinical practice regarding the management of pediatric lipid disorders.
- Contributes to the understanding of hyperlipidemia's role in cardiovascular health from childhood.
Abstract:
Hyperlipidemias represent one of the most important risk factors for the development of premature atherosclerotic disease. If prevention of ischaemic cardiovascular disease, which is responsible for about 50% of the deaths in Western Europe, should be successful, diagnosis and treatment of hyperlipidemic states should start as early as possible. A short overview concerning the composition and the metabolism of the lipoproteins is given and theoretical and practical aspects for the classification of the different forms of hyperlipoproteinemia during childhood are pointed out. Laboratory determinations are described and therapeutic approaches of the main pediatric hyperlipidemias are given: polygenetic and combined familial hyperlipidemias should be treated by diet alone, whereas familial hypercholesterolemias request drug treatment: cholestyramine, given in doses between 4 and 8 g seems to be the drug of choice. Possible future aspects of drug treatment are discussed, even those who are shown to increase the number of LDL-receptors, which are blocked in that disease. Finally, efforts are emphasized to screen all children of families, in which premature heart disease or hypercholesterolemia occur.