[Hyperlipoproteinemias in childhood].

There is general agreement that hyperlipidemic states, in particular hypercholesterolemia, should be diagnosed during childhood, and treatment should start beyond the age of 2 years. The rationale for this procedure is the fact that increased cholesterol levels have been accepted to act as major risk factors for coronary vascular disease in adult populations, and therefore the significance of cholesterol must be inferred from less direct evidence. The diagnosis of hyperlipidemias is based on reference levels for the various age groups which are mainly transferred from studies in the USA. The classification of hyperlipidemias refers to a clinical and genetic concept; thus, familial hypercholesterolemia (incidence 1:500) is the most important disorder for the pediatric age group. Treatment of affected children should include dietary restrictions, in particular for saturated fats, but substitution of animal protein by soy protein has been shown to increase the cholesterol lowering effect. It is concluded that children from families with cardiovascular disease and/or hyperlipidemias should be referred to a special metabolic clinic for appropriate diagnosis and treatment. So far, a general screening for hyperlipidemias is not recommended in the neonatal period or during childhood.