Clinical Report Emphasizes Pediatric Lipid Screening

Report replaces 1998 policy statement, recommends treatment of high-risk children

TUESDAY, July 8 (HealthDay News) -- Pediatricians should focus on cholesterol screenings for children and improving lipid and lipoprotein concentrations to reduce the long-term risk of cardiovascular disease, according to a clinical report published in the July issue of Pediatrics. The report -- "Lipid Screening and Cardiovascular Health in Childhood" -- replaces the 1998 policy statement from the American Academy of Pediatrics on cholesterol in childhood.

Stephen R. Daniels, M.D., Ph.D., Frank R. Greer, M.D., and members of the 2007-2008 Committee on Nutrition reviewed data -- most of which was unavailable in 1998 -- that addresses the long-term risks in children who consume excessive amounts of saturated fat, trans fats and cholesterol. They also reviewed recent data on carbohydrate intake, childhood obesity, metabolic/insulin-resistance syndrome, decreasing levels of physical activity and fitness, and the safety and efficacy of pharmacologic agents used to treat dyslipidemia.

Among their recommendations: pharmacological interventions should be considered in children ages 8 and older with a low-density lipoprotein (LDL) concentration at or above 190 mg/dL. It also should be considered if the LDL concentration is at or above 160 mg/dL in children with a family history of early heart disease or at least two additional risk factors, or if the level is at or above 130 mg/dL in children with diabetes.

"The approach to screening children and adolescents with a fasting lipid profile remains a targeted approach," the authors state. "Overweight children belong to a special risk category of children and are in need of cholesterol screening regardless of family history or other risk factors."

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