家族病史對於小朋友是否高血脂沒有太大關連-> 這些人會不會太過份?

AAP(American academy of pediatrics)建議有家族史的小朋友要做LDL檢查
160以上就要治療，但是家族史不是一個好的篩選指標


How Helpful Is Family History in Identifying Children with Elevated Cholesterol?

Screening on the basis of family history missed many children with hyperlipidemia.

In 2008, the American Academy of Pediatrics (AAP) released revised guidelines on lipid screening in children (JW Pediatr Adolesc Med July 16 2008) and reinforced the need for selective screening in children with positive family history of cardiovascular disease (parent with high cholesterol level, parent or grandparent with documented coronary artery disease before age 55). According to the guidelines, dyslipidemia in children is defined as low-density lipoprotein (LDL) levels ≥130 mg/dL, and drug therapy should be considered in children with consistent LDL levels ≥160 mg/dL despite diet therapy.

Investigators examined the accuracy of family history in identifying children with hyperlipidemia by using data from an ongoing study of 20,266 fifth graders in West Virginia who had fasting lipid profiles and whose parents completed family history questionnaires; 71% had positive family history, and 29% did not. Of those with positive family history, 8.3% had LDL levels ≥130 mg/dL and 1.2% had LDL levels ≥160 mg/dL. Of those with negative family history, 9.5% had LDL levels ≥130 mg/dL and 1.7% had LDL levels ≥160 mg/dL.

Comment: Regardless of whether you believe in screening and treating children with dyslipidemia, this study highlights two very important facts: (1) Family history is a poor way to identify children with elevated LDL cholesterol levels, and (2) about 1.5% of fifth-grade children would meet AAP guidelines for possible drug therapy, at least in this sample.

— Howard Bauchner, MD

Published in Journal Watch Pediatrics and Adolescent Medicine August 4, 2010
Citation(s):

Ritchie SK et al. Universal versus targeted blood cholesterol screening among youth: The CARDIAC project. Pediatrics 2010 Aug; 126:260. (http://dx.doi.org/10.1542/peds.2009-2546)

* Original article (Subscription may be required)
* Medline abstract (Free)

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