Dyslipidemia in pediatrician's practice

Rev Cardiovasc Med. 2021 Sep 24;22(3):817-834. doi: 10.31083/j.rcm2203088.

Abstract

Atherosclerosis ranks first among cardiovascular system diseases. It is the "disease of the century", and more than 50% of people with circulatory pathology die of it. The clinical manifestation of atherosclerosis is observed at the middle and older ages, but it is known that the pathological process develops much earlier. There has been a clear trend in theoretical and practical cardiology in recent years to study the earliest atherogenic markers. Epidemiological, clinical, and morphological studies have proved the presence in children and adolescents of sexual, endogenous, exogenous, primary, and potentiating risk factors contributing to an early formation of a pathogenic foundation for atherosclerotic cardiovascular diseases. Disorders of lipid metabolism - dyslipidemias are attributed to the most significant risk factor for atherosclerotic cardiovascular diseases. The DLP prevalence in the pediatric population is extremely high. According to the results of conducted global studies, lipid metabolism disorders occur in more than 70% of children and adolescents. It causes the need for timely diagnostic, therapeutic and preventive measures. The need to extrapolate the risk factor concept to childhood age is justified by several reasons, the main of which include the broadest spread of atherosclerosis that has become a global pandemic, genetic determinism, and low variability of the lipid spectrum of blood serum: the levels of lipids and lipoproteins discovered in childhood are stable throughout life and have an independent prognostic value. That is why the most practical significance is inherent to the study of lipid and lipoprotein metabolism, starting in the early periods of lipid and lipoprotein ontogenesis. Since risk factors can be identified at the preclinical stage of the atherosclerotic process, dyslipidemia phenotyping will facilitate identifying children and adolescents at risk of developing cardiovascular pathologies in the future. The study objective is to examine the pathophysiological aspects of lipid and lipoprotein metabolism and examine DLP epidemiology - as the leading atherosclerotic cardiovascular disease risk factor in children and adolescents, DLP classification, modern approaches to DLP diagnosis and management.

Keywords: Adolescents; Atherosclerosis; Children; Dyslipidemia; Risk factors.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Aged
  • Atherosclerosis* / diagnosis
  • Atherosclerosis* / epidemiology
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / therapy
  • Child
  • Dyslipidemias* / diagnosis
  • Dyslipidemias* / epidemiology
  • Humans
  • Lipids
  • Middle Aged
  • Pediatricians
  • Risk Factors

Substances

  • Lipids