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Examen de detección de trastornos lipídicos en niños y adolescentes: Declaración de recomendación del grupo de
, Kirsten Bibbins-Domingo1, David C Grossman2
1University of California, San Francisco.
JAMA
|August 18, 2016
Resumen
La evidencia actual es insuficiente para determinar los beneficios y daños de la detección de trastornos lipídicos en individuos de 20 años o menos. Se necesita más investigación para evaluar la efectividad de la detección y los resultados de salud cardiovascular a largo plazo.
Área de la Ciencia:
- Salud cardiovascular
- Salud pediátrica
- La medicina preventiva
Sus antecedentes:
- Los niveles elevados de colesterol y triglicéridos aumentan el riesgo de enfermedad cardiovascular en adultos.
- Los trastornos lipídicos en niños y adolescentes pueden predecir futuros eventos cardiovasculares.
- Las recomendaciones anteriores sobre el cribado de lípidos en poblaciones más jóvenes se establecieron en 2007.
Objetivo del estudio:
- Proporcionar una recomendación actualizada sobre el cribado de trastornos lipídicos en niños, adolescentes y adultos jóvenes.
- Evaluar la evidencia sobre el cribado de la hipercolesterolemia familiar heterocigótica y la dislipidemia multifactorial en individuos de 20 años o menos.
Principales métodos:
- Revisión sistemática de las pruebas de detección de trastornos lipídicos en poblaciones pediátricas.
- Las revisiones se centraron en el cribado de tipos específicos de dislipidemia (hipercolesterolemia familiar, multifactorial).
- Evaluación del rendimiento diagnóstico, la eficacia del tratamiento y los daños del cribado.
Principales resultados:
- Existen pruebas limitadas con respecto al rendimiento diagnóstico comparativo del cribado universal frente al selectivo.
- Los datos sobre la eficacia a largo plazo y los daños del tratamiento iniciado en la infancia son escasos.
- La asociación entre los resultados intermedios y la mejora de la salud cardiovascular en adultos no está bien establecida.
Conclusiones:
- El Grupo de Trabajo de Servicios Preventivos de los Estados Unidos (USPSTF) encontró evidencia insuficiente para evaluar el equilibrio de beneficios y daños de la detección de trastornos lipídicos en individuos de 20 años o menos.
- El USPSTF emitió una recomendación de grado I, indicando evidencia insuficiente.
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