Outcomes of Dyslipidemia Screening Program in School-Aged Children

INTRODUCTION: Screening of dyslipidemia in childhood has been controversial. While some guidelines recommend screening of dyslipidemia in children, others emphasize that there is insufficient evidence for screening of dyslipidemia in those less than 20 years of age. In this study, we aimed to evaluate the outcomes of lipid screening program and reveal the pros and cons of the program.
METHODS: All patients referred to pediatric metabolism outpatient clinic by family physicians with the suspicion of dyslipidemia in lipid screening program at schools were investigated.
Demographic and physical examination findings, screening lipid profile and fasting control lipid profile of patients were evaluated. Definitive diagnosis with fasting lipid profile and genetic analysis were recorded.

RESULTS: Two hundred seventy-four patients suspected with dyslipidemia were enrolled in the study. The mean age of study group was 9.2±3.2 (5-17) years.
While 158 (57.7%) patients were admitted with high total cholesterol and low-density lipoprotein cholesterol, high triglyceride level was detected in 58 (21.2%) patients with pediatric lipid screening program. High total cholesterol level was revealed in 26 (9.5%) patients.
With the control fasting lipid profile 100 (36.5%) patients had normal lipid profile. As 59 (21.5%) patients diagnosed with familial hypercholesterolemia, hyperchylomicronemia and hypobetalipoproteinemia were revealed in 5 (1.8%) and 4 (1.5%) patients, respectively.
Eleven patients diagnosed with familial hypercholesterolemia did not declare hyperlipidemia in parents. In the family screening of these patients, 11 parents and 3 siblings were diagnosed with familial hyperlipidemia.

DISCUSSION AND CONCLUSION: This is the first study performed to date that evaluated the outcomes of lipid screening program at school age children in Turkey. We found that screening program is effective to diagnose not only the patients but also asymptomatic parents and siblings. Evaluation and verification of dyslipidemia should be performed in fasting status to avoid false positive results.