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Recognition and management of dyslipidemia in children and adolescents.
- Source :
-
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2008 Nov; Vol. 93 (11), pp. 4200-9. Date of Electronic Publication: 2008 Aug 12. - Publication Year :
- 2008
-
Abstract
- Context: Cardiovascular disease (CVD) remains the number one cause of death in the United States. The origins of atherosclerosis and CVD begin in childhood. Dyslipidemia and obesity are endemic in American youth and require urgent action.<br />Evidence Acquisition: A detailed literature search from 1985-2008 was performed using PubMed and subsequent reference searches of retrieved articles. Selection of included articles was based on rigor of scientific design, adequate sample size, quality of the data, statistical analysis, and hypothesis testing.<br />Evidence Synthesis: CVD risk factors in children predict pathological lesions of atherosclerosis in young adults, and their clinical manifestations, as judged by carotid intima medial thickness, coronary artery calcium, or brachial flow-mediated dilatation. About half the offspring of a parent with premature CVD have a primary dyslipidemia. However, use of family history to identify such youth will miss the majority of children with dyslipidemia. Treatment of dyslipidemia starts with a low-fat diet supplemented with water-soluble fiber, plant stanols, and plant sterols, weight control, and exercise. Drug therapy with inhibitors of hydroxymethylglutaryl coenzyme A reductase, bile acid sequestrants (BAS), and cholesterol absorption inhibitors can be considered in adolescents with a positive family history of premature CVD and a low-density lipoprotein cholesterol of more than 160 mg/dL. Such dietary and drug therapy appears safe and efficacious and is likely to retard atherosclerosis.<br />Conclusions: Early identification and treatment of youth at risk for early atherosclerosis will require an integrated assessment of predisposing CVD risk factors and a comprehensive universal screening and treatment program.
- Subjects :
- Adolescent
Atherosclerosis blood
Atherosclerosis mortality
Cardiovascular Diseases blood
Cardiovascular Diseases mortality
Child
Cholesterol blood
Coronary Disease epidemiology
Dyslipidemias blood
Dyslipidemias complications
Humans
Hypercholesterolemia blood
Hypercholesterolemia epidemiology
Lipoproteins blood
Mass Screening
Obesity complications
Risk Factors
United States epidemiology
Atherosclerosis epidemiology
Cardiovascular Diseases epidemiology
Dyslipidemias diagnosis
Dyslipidemias therapy
Obesity diagnosis
Obesity therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0021-972X
- Volume :
- 93
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 18697860
- Full Text :
- https://doi.org/10.1210/jc.2008-1270