Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
Expert Rev Cardiovasc Ther. 2023 Jul-Dec;21(7):463-471. doi: 10.1080/14779072.2023.2218087. Epub 2023 May 27.
Atherosclerotic cardiovascular disease (ASCVD) is the main cause of morbidity and mortality worldwide. Dyslipidemia, in particular elevation of LDL-cholesterol levels (LDL-C), is one of the major cardiovascular risk factors and is characterized by high prevalence and independent unfavorable impact on cardiovascular prognosis; however, because of its asymptomatic course, it often remains undiagnosed. Strategies aimed at early identification of subjects with elevated LDL-C levels may allow early intervention, preventing ASCVD development.
The purpose of this review is to summarize the recommendations of current guidelines by leading scientific authorities on the pros and cons of lipid profile screening programs.
Systematic assessment of LDL-C levels as part of global cardiovascular risk assessment in all adults is a cornerstone of ASCVD risk prevention. In young adults, adolescents, and children, selective lipid profile screening may be useful to reduce the impact of high cholesterol levels on ASCVD risk in the presence of specific conditions including either family history of early ASCVD or multiple concomitant cardiovascular risk factors. Cascade screening for family members of individuals diagnosed with familial hypercholesterolemia (FH) may be also of great clinical impact. Further evidence is needed to evaluate the cost/benefit ratio of systematic assessment of lipid profile in children, adolescents, and young adults.
动脉粥样硬化性心血管疾病（ASCVD）是全球发病率和死亡率的主要原因。血脂异常，特别是 LDL 胆固醇（LDL-C）水平升高，是主要的心血管危险因素之一，其特点是患病率高，对心血管预后有独立的不利影响；然而，由于其无症状的病程，往往未被诊断。旨在早期发现 LDL-C 水平升高的患者的策略可能允许早期干预，从而预防 ASCVD 的发生。
本综述的目的是总结主要科学权威机构关于血脂谱筛查计划利弊的现行指南建议。
在所有成年人中，系统评估 LDL-C 水平作为 ASCVD 风险预防的全球心血管风险评估的一部分是基石。在年轻成年人、青少年和儿童中，选择性血脂谱筛查可能有助于在存在特定条件（包括早发 ASCVD 的家族史或多种并存心血管危险因素）的情况下降低高胆固醇水平对 ASCVD 风险的影响。对诊断为家族性高胆固醇血症（FH）的个体的家庭成员进行级联筛查也可能具有重要的临床意义。需要进一步的证据来评估在儿童、青少年和年轻成年人中系统评估血脂谱的成本效益比。
