Mosca Sara, Araújo Graça, Costa Vanessa, Correia Joana, Bandeira Anabela, Martins Esmeralda, Mansilha Helena, Tavares Mónica, Coelho Margarida P
Pediatrics Department, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto 4050-651, Portugal.
Pediatrics Department, Hospital Central do Funchal, Funchal 9000-177, Portugal.
J Nutr Metab. 2022 Feb 21;2022:4782344. doi: 10.1155/2022/4782344. eCollection 2022.
Dyslipidemias or dyslipoproteinemias are quantitative changes in total cholesterol concentration, respective fractions, or triglycerides in the plasma. Evidence supported that dyslipidemia in childhood is associated with atherosclerosis in adulthood, and early identification and treatment potentially reduce cardiovascular risk in adulthood, which is the principal cause of morbidity and mortality in developed countries. Dyslipidemias can result from primary lipoprotein metabolism changes due to different genetic causes (primary dyslipidemias) or as a consequence of exogenous factors or other pathologies (secondary dyslipidemias). Therefore, the combined dyslipidemias result from the association of important epigenetic and environmental influences with risk factors for cardiovascular disease. The criterion for lipid metabolism screening at young ages is not widely accepted and possibly follows a universal or directed screening strategy. Additionally, little is known about its long-term effects or possible risk-benefit despite the growing tendency to start pharmacological therapy. Therefore, this study aimed to review the available bibliography on dyslipidemia in pediatric age to present a practical and structured approach to dyslipidemia that focuses on screening, risk stratification for atherosclerotic disease, and therapeutic approach.
血脂异常或脂蛋白异常血症是指血浆中总胆固醇浓度、各组分或甘油三酯的定量变化。有证据表明,儿童期血脂异常与成年期动脉粥样硬化有关,早期识别和治疗可能降低成年期心血管疾病风险,而心血管疾病是发达国家发病和死亡的主要原因。血脂异常可能源于不同遗传原因导致的原发性脂蛋白代谢变化(原发性血脂异常),或外源性因素或其他病理状况的结果(继发性血脂异常)。因此,合并性血脂异常是重要的表观遗传和环境影响与心血管疾病危险因素共同作用的结果。在年轻人群中进行脂质代谢筛查的标准尚未得到广泛认可,可能遵循通用或针对性的筛查策略。此外,尽管开始药物治疗的趋势日益增加,但对其长期影响或可能的风险效益知之甚少。因此,本研究旨在回顾有关儿童期血脂异常的现有文献,以提出一种实用且结构化的血脂异常处理方法,重点关注筛查、动脉粥样硬化疾病风险分层和治疗方法。