Kid cholesterol

By Dr. Ananya Mandal, MDJul 13 2010

Dr Ananya Mandal, MD

According to a new study published in the 12^th July issue of the journal Pediatrics, one third of kids have blood cholesterol on the higher side and these levels might be overlooked with the current screening recommendations.

Higher levels of bad cholesterol, LDL (over 160 mg/dL) are a direct risk factor of type 2 diabetes and heart attacks in early adulthood. It is time for more awareness feels Dr. William Neal, professor of pediatrics at West Virginia University, Morgantown. He said that children whose parents or grandparents have or had high cholesterol should be routinely checked. He found that the actual number of tested children was appallingly low and thus decided upon this study.

Neal and colleagues offered comprehensive screening, including blood cholesterol tests, to every fifth-grade child in West Virginia. They found that more than 70% of these 20,266 kids needed testing but were not getting it. This is as per the current National Cholesterol Education Program (NCEP) guidelines. Also horrifying was the fact that many kids who would not have qualified for screening need as per the guidelines had high cholesterol. Dr. Neal said, “Just as many kids who would not have been screened ended up with severely high cholesterol levels as in the group that did qualify for screening based on family history.” Normal LDL cholesterol level in 2-19 year olds is under 130 mg/dL.

For example:

• 8.3% 11-year-olds who met current cholesterol screening guidelines had LDL cholesterol levels of 130 mg/dL or higher. 1.2% had higher than 160mg/dL.
• 9.5%11-year-olds who would not have been screened under current guidelines had LDL cholesterol levels of 130 mg/dL or higher. 1.7% had LDL cholesterol levels of 160 mg/dL or higher

Dr. Neal says that guidelines and recommendations need to be revised. He said, “…as time has gone on, one of the indicators that triggers screening is a condition such as high blood pressure or obesity in the child…You may have children for whom the family history of heart disease may not be positive, but their doctors will lean more toward screening as they worry about diabetes in addition to heart disease.” He feels that all children should be tested for high cholesterol.

American Heart Association President Ralph Sacco, chair of neurology at the University of Miami however feels differently, “This study does call into question whether family history is a good enough indicator for screening, but whether to jump to universal screening is another question… The rising epidemic of diabetes means we need to focus on diet, weight control, and physical activity. Putting the emphasis on this for fifth graders would be of utmost importance.” Thus he says it is not screening that is the key but a healthier lifestyle for children that can keep diabetes and heart disease at bay. Some children despite a healthy lifestyle, say both doctors may still need drugs to control their blood cholesterol levels.