Definition

Dyslipidemia refers to the presence of abnormal quantities of fat or lipids in the blood. Over time, dyslipidemia can lead to the accumulation of fat and the calcification of the arteries. Cholesterol is a component of the lipids produced by the liver. Cholesterol is also found in certain food items. The body uses cholesterol to synthesize cells, vitamins, and hormones. Nevertheless, elevated cholesterol levels might lead to complications across different age groups. Cholesterol comprises two primary types.  Low-density lipoprotein (LDL), often known as bad cholesterol, can build up on blood vessel walls, leading to blockages.  High-density lipoprotein (HDL), the second form of lipoprotein, is commonly referred to as good cholesterol due to its role in transporting LDL cholesterol away from the arteries.

Cause

Obesity, poor nutrition, and lifestyle are common factors that contribute to dyslipidemia in children and adolescents. This disorder can be hereditary.

Risk factors

Several risk factors associated with dyslipidemia in children include the following:

• A familial predisposition to cardiovascular disease occurs in men under the age of 55 and women under the age of 65.
• high-cholesterol parents,
• obesity
• diabetes

Symptoms

Children with dyslipidemia typically do not exhibit elevated cholesterol symptoms, necessitating regular cholesterol level assessments to determine the condition. In addition, it is essential to schedule regular checkups if the children have high-risk indicators.

Diagnosis

Dyslipidemia in children can be diagnosed by analyzing the lipid profile through laboratory tests. This evaluation is advised for both asymptomatic children and children with a familial predisposition to hypercholesterolemia. The examination is conducted once between 9 and 11 and again between 18 and 21. It is important to test children who are at risk of dyslipidemia from an early age, ideally about 2 years old, and to do regular check-ups after that. Typically, cholesterol levels are as follows:

Management

The Society for Cardiovascular Angiography and Interventions recommends lifestyle modifications, including:

• Eat more fruits and vegetables.
• Replace butter and animal fat with vegetable oil and margarine.
• Replace bread and cereal with whole grains
• Eliminate sugary food and drinks.
• Drink low-fat milk
• Consume lean meat and fish.
• Avoid consuming chicken skin.
• Eat less salt.
• Learn about a balanced diet.
• Exercise daily for an hour.

Furthermore, the doctor may also recommend using statins, which are pharmaceuticals formulated to reduce cholesterol levels. Research has demonstrated that statins are a safe pharmacological intervention for treating dyslipidemia in children. However, the long-term effects of this medication remain undetermined. Typically, statin medication can be prescribed to children aged 8 to 10 years.

There are several factors to consider when prescribing statins, including:

• The age range is 8–10 years old.
• LDL is above 190 mg/dL or after 6 months of a healthy lifestyle,
• Significant risk factors or LDL above 160 mg/dL,
• Family history of cardiovascular disease
• One or more cardiovascular risk factors.

Children with elevated cholesterol may need statins at 10 years old. An improved diet and lifestyle help children maintain normal cholesterol levels. Genetic dyslipidemia in children may require lifetime medication and blood cholesterol monitoring.

Complications

Pediatric patients diagnosed with dyslipidemia exhibit elevated levels of cholesterol, hence increasing their risk of complications, including:

• Myocardial infarction
• Stroke
• Cardiovascular diseases
• Chronic kidney disease

Prevention 

The American Heart Association (AHA) suggests the following preventions to lower the risk of developing elevated cholesterol:

• Exercise regularly.
• Maintain healthy weight
• Nutritious diet

When to see a doctor?

Parents should routinely monitor their children's cholesterol levels. Generally, teenagers do not exhibit any symptoms of high cholesterol; therefore, routine examinations are necessary.

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