Lipid Panel Pediatric
The increasing prevalence of obesity has led to a much larger population of children with dyslipidemia. Today, the predominant dyslipidemic pattern in childhood is a combination of moderate to severe elevation in triglycerides, normal to mild elevation in LDL cholesterol, and reduced HDL cholesterol level. This pattern has been associated with initiation and progression of atherosclerosis in children and adolescents.
Previous studies have repeatedly demonstrated that solely relying on family history of premature cardiovascular disease or cholesterol disorders misses 30 to 60% of children with dysplipidemia. Recently, an expert panel sponsored by the National Heart, Lung, and Blood Institute (NHLBI) and endorsed by the American Academy of Pediatrics issued comprehensive guidelines on cardiovascular health and risk reduction in children and adolescents that included universal screening of children at ages 9–11 and again at ages 17–19 (Pediatrics 2011;128: S213-256).
The expert panel published the following cut-points for low, acceptable, borderline, and high lipid levels in children and adolescents up to age 19.
|
|
Acceptable |
Borderline |
High |
|
Total Cholesterol |
<170 |
170–199 |
?200 |
|
LDL Cholesterol |
<110 |
110–129 |
?130 |
|
Non-HDL Cholesterol |
<120 |
120–144 |
?145 |
|
HDL Cholesterol |
>45 |
|
|
|
Triglycerides |
<75 |
75–99 |
?100 |
|
Triglycerides |
<90 |
90–129 |
?130 |
It is important to note that non-HDL cholesterol was included in the lipid screening panel. Non-HDL cholesterol has been shown to be a more significant predictor of persistent dyslipidemia and atherosclerosis in children and adolescents than total cholesterol, LDL cholesterol or HDL cholesterol alone. A major advantage of non-HDL cholesterol is that it can be accurately calculated in nonfasting specimens with elevated triglycerides.
