Stewart Jeremy, McCallin Tracy, Martinez Julian, Chacko Sheebu, Yusuf Shabana
Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, The Children's Hospital of San Antonio, San Antonio, TX.
Office of Student Affairs, Baylor College of Medicine, Houston, TX.
Pediatr Rev. 2020 Aug;41(8):393-402. doi: 10.1542/pir.2019-0053.
Cardiovascular disease remains the top cause of morbidity and mortality in the United States. Atherosclerotic plaques are known to start in adolescence, and, therefore, young adults can be affected by coronary artery disease. Children with known risk factors, such as genetic predisposition, including familial hyperlipidemias, diabetes, and renal diseases, are at higher risk. With childhood obesity becoming an epidemic in certain parts of the United States, this problem is further highlighted as an important issue affecting children's health. There are unclear recommendations for pediatricians regarding cholesterol screening of pediatric populations, when to initiate hyperlipidemia treatment with statin therapy, and when to refer to a specialist for further management. This article reviews the epidemiology and pathophysiology of hyperlipidemia, recommendations for screening and types of screening, management (including pharmacology), prognosis, and prevention.
心血管疾病仍然是美国发病和死亡的首要原因。已知动脉粥样硬化斑块始于青春期，因此，年轻人可能会受到冠状动脉疾病的影响。具有已知风险因素的儿童，如遗传易感性，包括家族性高脂血症、糖尿病和肾脏疾病，风险更高。随着儿童肥胖在美国某些地区成为一种流行病，这个问题作为影响儿童健康的一个重要问题被进一步凸显出来。对于儿科医生来说，关于儿科人群的胆固醇筛查、何时开始用他汀类药物治疗高脂血症以及何时转诊给专科医生进行进一步管理，目前尚无明确的建议。本文综述了高脂血症的流行病学和病理生理学、筛查建议和筛查类型、管理（包括药理学）、预后和预防。
