Cut points for lipids and lipoproteins in children and adolescents: should they be reassessed?

摘要

Antecedent plasma concentrations of lipids and lipoproteins are associated with both early pathologic lesions of atherosclerosis and arterial changes in vivo, such as carotid intima media thickness (IMT) and en-dothelial dysfunction (1, 2). Healthy normolipidemic Finnish children, treated with a low-saturated fat, low-cholesterol diet from the age of 7 months to 11 years, had less carotid IMT than controls. In Dutch children and adolescents with heterozygous familial hypercho-lesterolemia (FH), treatment for 2 years with a similar diet and an inhibitor of hydroxymethylglutaryl CoA reductase led to decreased carotid IMT compared to IMT in FH children treated with diet and placebo. Impaired endothelial dysfunction in FH children, as judged by flow-mediated dilation, improved significantly in those treated with simvastatin vs those on placebo, to a level similar to that in healthy non-FH controls.