Universal Childhood Lipid Screening

Screening for lipid disorders in children and adolescents can identify 2 types of lipid disorders: primary lipid disorders, which typically are monogenic, rare, and severe, and the more common secondary lipid disorders that often result from other disease processes or lifestyle behaviors (such as poor nutrition or inadequate activity) and are often less severe. The most common primary lipid disorder of childhood is familial hypercholesterolemia (FH), which is present in 1 in 250 to 350 children. Familial hypercholesterolemia causes markedly elevated levels of low-density lipoprotein cholesterol (LDL-C) starting at birth, and, if untreated, is associated with a 2- to 4-fold increase in morbidity and mortality from coronary heart disease in adulthood. Because of the relatively high prevalence and substantial long-term health risks of FH, the US Centers for Disease Control and Prevention previously designated it as a “tier 1” genetic condition, defined as having the potential for significant positive impact on public health if identified and treated. The opportunity to identify and treat FH earlier is the main motivation for childhood lipid screening.