A lipid profile tests for concentrations of different types of cholesterol and other kinds of fats present in an individual's blood. While lipid profile tests are standard tests in adults, their use in children is less apparent. Children who are considered at risk may be advised to undergo a test. Cholesterol is an essential nutrient needed to sustain life, but excessive amounts of this molecule may be associated with a disease of the blood vessels, known as atherosclerosis.
Understanding Lipid Profiles
The lipid profile is made up of a number of measurements. The low-density lipoprotein, sometimes called "bad" cholesterol or LDL, is the most important parameter that doctors look at. Acceptable levels are below 110 milligrams per deciliter; values in excess of 130 milligrams per deciliter are classified as high. High-density lipoprotein, also known as "good" cholesterol or HDL, is protective against heart disease. Healthy levels are HDL are greater than 45 milligrams per deciliter. Total triglycerides in blood should be less than 150 milligrams per deciliter; this measurement is less appropriate in determining atherosclerosis risk.
Child Didn't Fast
The most common cause of a high lipid panel in children was that the child didn't fast. Lipid profiles should be done following eight to 10 hours of fasting. If this is not done, the profile may be spuriously high. Parents should ensure their kids fast overnight before doing the laboratory test.
High Cholesterol
According to the American Academy of Pediatrics, children reach baseline levels of cholesterol at 2 years of age. Children with a family history of heart disease and stroke are recommended for screening after 2 years but before 10 years of age. Atherosclerosis, a disease of blood vessels that causes these conditions, starts occurring in childhood. Testing for lipids is an indirect method to test for atherosclerosis. While it may be a way to identify those at most risk, cholesterol has variations in respect to age, sex and ethnicity. Determining the normal level for each population group may be difficult.
Familial Hypercholesterolemia
Familial hypercholesterolemia is a genetic disease that can be inherited in children. It is autosomal dominant, meaning that there may be a history of having heart attacks at a young age in either of the parents. Rarely, the disease can be inherited from both parents, creating an even more serious condition. The defect is in the cellular receptors for LDL. Total cholesterol levels may be greater 250 milligrams per deciliter in these children. LDL levels may be greater than 220 milligrams per deciliter. Other symptoms of hypercholesterolemia include cholesterol deposits under the skin and in the eyelids, and symptoms of chest pain, signifying heart disease.
Treating High Cholesterol
Dietary and lifestyle modifications are important. Parents should give their kids foods low in saturated fat and cholesterol. Fewer than 30 percent of calories should come from fats. The use of low-fat dairy products is recommended by the American Academy of Pediatrics. Regular aerobic exercise can lower LDL cholesterol and increase HDL. Doctors may prescribe cholesterol-lowering medications in at-risk children over 8 years of age if their cholesterol exceeds 160 milligrams per deciliter. Commonly prescribed medications include cholestyramine, colestipol and colesevelam. Statin drugs, such as atorvastatin and simvastatin, are beneficial in children with familial hypercholesterolemia.
References
- "Pediatrics"; Lipid Screening and Cardiovascular Health in Childhood; Stephen R. Daniels, MD, PhD, et al.; July 2008
- PubMed Health: Familial Hypercholesterolemia
- Cleveland Clinic: High Cholesterol in Children
- "Circulation"; Statin Treatment in Children With Familial Hypercholesterolemia; Jessica Rodenburg, MD, PhD, et al.; 2007
- Children's Hospital Boston: LDL, HDL and Triglycerides
