Elevated levels of lipoprotein (a) in children with familial hypercholesterolemia

Lipoprotein(a)[Lp(a)] concentrations and their correlation to total cholesterol (TC), low-density and high-density lipoprotein cholesterol (LDL-C, HDL-C) and triglycerides (TG) were estimated in 20 normal weight children affected with familial hypercholesterolemia (FH) and for comparison in 20 overweight, but otherwise healthy children, matched for sex and age. The mean value of Lp(a) in patients with FH (0.29 g/l, SD = 0.27) was markedly higher than in the control group (0.17g/l, SD = 0.19), but the difference was not statistically significant. However, the frequency distribution of Lp(a) in both groups was different: the proportion of Lp(a) levels above 0.60g/l was significantly greater in patients with FH than in the controls (p < 0.05). These results indicate that even pediatric patients with FH have increased Lp(a) levels. Since Lp(a) elevation above 0.25 to 0.30g/l--in particular in combination with increased LDL concentrations--is is associated with a markedly increased risk of coronary heart disease, cervical atherosclerosis and cerebral infarction, it seems very important to detect these high-risk individuals as early as possible and to treat them appropriately.