Published online January 3, 2005
PEDIATRICS Vol. 115 No. 1 January 2005, pp. 195-196 (doi:10.1542/peds.2004-1947)
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Lipid Screening

Robert D. Corwin, MD
Providence, RI 02905

Charlotte M. Boney, MD
Department of Pediatrics,
Brown Medical School,
Providence, RI 02903
Pediatric Lipid Clinic,
Hasbro Children's Hospital,
Providence, RI 02903

To the Editor.—

We are writing about our concern regarding the approach to familial lipid disorders as revealed by the article "Usefulness of the American Academy of Pediatrics Recommendations for Identifying Youths With Hypercholesterolemia" in the June 2004 issue of Pediatrics.

Genetic lipid disorders such as familial combined hyperlipidemia, familial hypercholesterolemia, and hypoalphalipoproteinemia require ongoing lipid screening for triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A-1, and apolipoprotein B if there is a family history for premature cardiovascular disease (ie, a male <55 years old or a female <65 years old who has had a "heart attack" or stroke). This family history is more important than a history of high cholesterol.

We agree with the authors that a parent history of high cholesterol is not very useful: it may not be known by the parents, both parents may not be available, or they are too young to have had it checked themselves! Often the grandparent history is more helpful in regard to cholesterol levels and early heart disease or stroke. We agree that current screening recommendations for elevated cholesterol are not often helpful, but asking about a family history of premature cardiovascular disease is often revealing if there is a primary, genetic lipid abnormality.

We suggest that a commentary regarding more appropriate screening for familial lipid disorders would be helpful to practitioners.

REFERENCE

  1. O'Loughlin J, Lauzon B, Paradis G, et al. Usefulness of the American Academy of Pediatrics recommendations for identifying youths with hypercholesterolemia. Pediatrics. 2004;113 :1723 –1727[Abstract/Free Full Text]
PEDIATRICS (ISSN 1098-4275). ©2005 by the American Academy of Pediatrics

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This Article
Right arrow Extract Freely available
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Citing Articles
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Google Scholar
Right arrow Articles by Corwin, R. D.
Right arrow Articles by Boney, C. M.
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PubMed
Right arrow PubMed Citation
Right arrow Articles by Corwin, R. D.
Right arrow Articles by Boney, C. M.
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