Garcia R E, Moodie D S
Department of Pediatrics, Cleveland Ohio Clinic Foundation 44195-5223.
Am J Dis Child. 1991 Feb;145(2):147-50. doi: 10.1001/archpedi.1991.02160020037011.
Atherosclerosis is a process that begins in early life. Coronary heart disease is the result of complex interactions among a variety of risk factors of which hypercholesterolemia is but one. During routine screening, 500 children were identified with total cholesterol levels above the 95th percentile of 5.2 mmol/L (200 mg/dL). Lipoprotein profiles were then performed to confirm and delineate their lipid abnormalities. A definable lipid disorder was present in 85% of such children. Abnormal lipoprotein patterns included 292 children with type IIa, 99 with type IIb, and 25 with type IV phenotypes. An abnormally low high-density lipoprotein cholesterol level of less than 0.9 mmol/L (35 mg/dL) was observed in 20 children. Only 5% of patients were identified as being hypercholesterolemic because they had high-density lipoprotein cholesterol levels above the 95th percentile of 1.8 mmol/L (70 mg/dL). Thirty-two percent of children with total cholesterol levels above 5.2 mmol/L had a family member (sibling, parent, uncle, aunt, or grandparent) with a myocardial infarction prior to 55 years of age. Data from this study support universal cholesterol testing after 3 years of age and lipoprotein profiles for those with levels above 5.2 mmol/L.
动脉粥样硬化是一个始于生命早期的过程。冠心病是多种危险因素之间复杂相互作用的结果，其中高胆固醇血症只是其中之一。在常规筛查中，发现500名儿童的总胆固醇水平高于5.2 mmol/L（200 mg/dL）的第95百分位数。随后进行脂蛋白谱分析以确认并描述他们的脂质异常情况。85%的此类儿童存在可明确的脂质紊乱。异常脂蛋白模式包括292名IIa型、99名IIb型和25名IV型表型的儿童。20名儿童观察到高密度脂蛋白胆固醇水平异常低，低于0.9 mmol/L（35 mg/dL）。只有5%的患者被确定为高胆固醇血症，因为他们的高密度脂蛋白胆固醇水平高于1.8 mmol/L（70 mg/dL）的第95百分位数。总胆固醇水平高于5.2 mmol/L的儿童中有32%有家庭成员（兄弟姐妹、父母、叔叔、阿姨或祖父母）在55岁之前发生过心肌梗死。这项研究的数据支持3岁后进行普遍的胆固醇检测以及对胆固醇水平高于5.2 mmol/L的儿童进行脂蛋白谱分析。
