Hyperlipidemia is an elevation of serum lipids. These lipids include cholesterol, cholesterol esters (compounds), phospholipids, and triglycerides. Lipids are transported as part of large molecules called lipoproteins.
- Five major families of lipoproteins:
- Very-low-density lipoproteins (VLDLs)
- Intermediate-density lipoproteins (IDLs)
- Low-density lipoproteins (LDLs)
- High-density lipoproteins (HDLs)
- Normal serum lipid concentrations:
- Total cholesterol: 170 mg/dL (borderline, 170 to 199 mg/dL)
- LDL cholesterol: <110 mg/dL (borderline, 110 to 129 mg/dL)
- HDL cholesterol: ≥45 mg/dL (low <40 mg/dL)
- Total triglycerides: 100 mg/dL (borderline, 100 to 140 mg/dL)
- Non-HDL: <120 mg/dL (borderline, 120 to 144 mg/dL)
- Non-HDL cholesterol is a significant predictor of the presence of atherosclerosis in children and as powerful as any other lipoprotein cholesterol measure. It can be measured nonfasting and should be added as a screening tool for dyslipidemia.
- More detailed age- and gender-specific values are available (refer to Table 2 of Lipid Screening and Cardiovascular Health in Childhood).
- Primary hypercholesterolemia or hypertriglyceridemia: elevation in serum cholesterol or triglyceride as a result of an inherited disorder of lipid metabolism (i.e., familial hypercholesterolemia [FH])
- Secondary hypercholesterolemia or hypertriglyceridemia: elevation in serum cholesterol or triglyceride as a result of another disease process (e.g., diabetes mellitus)
- The prevalence of homozygous FH is 1 in 1,000,000; the prevalence of the heterozygous state is 1 in 500.
- Overall, hypercholesterolemia and/or hypertriglyceridemia of unknown causes occur in 2% of the pediatric population.
- National Health and Nutrition Exam Surveys (NHANES I to III) provide information about normal pediatric serum cholesterol concentrations.
- For all children 4 to 17 years, the 95th percentile for serum total cholesterol is 216 mg/dL and the 75th percentile is 181 mg/dL.
- The average total and LDL cholesterol levels before puberty are significantly higher in girls than they are in boys.
- The mean total cholesterol level for all children from 4 to 11 years old peaks at age 9 to 11 years and then gradually decreases until mid to late adolescence.
- FH: dominantly inherited defect of LDL receptor
- Familial combined hyperlipidemia (FCHL): dominantly inherited lipid disorder, polygenic
- Familial hypertriglyceridemia (FHTG): autosomal recessive disorder due to defects in lipoprotein lipase
- Fat intake is generally unrestricted prior to 2 years of age. After age 2 years, two complementary approaches are recommended:
- Diet and lifestyle guidelines to promote:
- Consumption of an overall healthy diet
- A healthy body weight (BMI between the 5% and 85% for age and sex, in adults 18.5 to 24.9 kg/m2)
- Diet and lifestyle guidelines to promote:
- Recommended lipid levels:
- LDL cholesterol <110 mg/dL
- HDL cholesterol >50 mg/dL in women, >40 mg/dL in men
- Triglycerides <150 mg/dL
- Normal BP (age appropriate)
- Normal blood glucose (fasting blood glucose ≤100 mg/dL)
- Being physically active
- Avoiding use of and exposure to tobacco products
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Cabana, Michael D., editor. "Hyperlipidemia." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617235/all/Hyperlipidemia.
Hyperlipidemia. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617235/all/Hyperlipidemia. Accessed May 28, 2023.
Hyperlipidemia. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617235/all/Hyperlipidemia
Hyperlipidemia [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2023 May 28]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617235/all/Hyperlipidemia.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Hyperlipidemia ID - 617235 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617235/all/Hyperlipidemia PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -