Article
Hereditary dyslipidaemias and combined risk factors in children
with a family history of premature coronary artery disease
T Svegera, C-E Flodmarka, K Nordborga, P Nilsson-Ehleb, N Borgforsc
a Department of
Paediatrics, Malmö University Hospital, S-205 02 Malmö, Sweden, b Department of Clinical Chemistry, Lund
University Hospital, Lund, Sweden, c School Health Service, Malmö, Sweden
Correspondence to: Dr Sveger
Accepted 4 November
1999
AIM
Schoolchildren
aged 10-11 with a family history of premature coronary artery disease
(CAD), were examined in order to identify children with genetically
determined dyslipidaemias and a combination of risk factors.
METHODSA total of
4000 questionnaires were distributed by the school; 55% of the
families answered and returned the questionnaire. Blood lipids,
apolipoprotein B, and Lp(a) lipoprotein were analysed in high risk
children and their parents.
RESULTSA family
history of premature CAD in parents or grandparents was identified in
208 families; 175 agreed to take part in a clinical examination and
laboratory tests. Normal blood lipid tests were found in 89 children.
Another 48 had an isolated increase of Lp(a) lipoprotein of minor
clinical importance. Of the remaining 38 children, 23 had
non-hereditary abnormalities of low (LDL) or high density lipoprotein
(HDL) cholesterol or apolipoprotein B. Fifteen children were suspected
to have genetically determined dyslipidaemias or a combination of risk
factors: in four, possible familial hypercholesterolaemia (FH); in
five, possible familial combined hyperlipidaemia; in three, hereditary
low HDL cholesterol; and in three a combination of high LDL cholesterol
and Lp(a) lipoprotein concentrations. In addition, possible FH was
detected in eight of the parents.
CONCLUSIONIt is
worthwhile asking parents about the occurrence of premature CAD among
their child's closest relatives.
Keywords: preventive cardiology; dyslipidaemia; coronary artery disease
© 2000 by Archives of Disease in Childhood
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