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Study calls for cholesterol test
in kids aged 15 months
17 September, 2007
A simple blood test at the age of 15
months could identify children with
familial hypercholesterolemia, a
genetic condition that causes high
cholesterol levels and increases
greatly the risk of early death from
heart disease.
A study conducted in the United
Kingdom has found that treatment with
drugs could eventually be started to
reduce that risk. There is a side
benefit: parents unaware that they
were carrying the gene for the
condition could be identified.
According to Dr David Wald, lead
author of the study report, no
elaborate genetic test is needed; just
a blood reading would do to find which
children have abnormally high levels
of low-density lipoprotein (LDL)
cholesterol – or, the ‘bad’
cholesterol associated with blockage
of arteries.
The findings have been published
online on September 15, 2007, in the
British Medical Journal.
An analysis of 13 studies that
included 1,907 people with the
condition showed that screening was
most effective when done early in
childhood, says Dr David Wald, a
consultant cardiologist and senior
lecturer at the Wolfson Institute of
Preventive Medicine in London.
Dr Wald and colleagues are planning “a
limited-implementation study that is
necessary to establish feasibility.”
The proposal is to include a
cholesterol test at about 15 months of
age, as part of a child’s normal
health-care routine.
Screening newborns or young adults was
much less effective, the report said.
The study showed that a test would
identify 88% of cases of familial
hypercholesterolemia, with only one in
1,000 misidentified.
The more common form of the condition,
caused by a single gene, is estimated
to affect 1 in every 500 people in the
United Kingdom and the United States.
There are rare, much more severe cases
of the disorder in which someone
carries two faulty genes.
The test proposed in the study report
would look for a blood LDL cholesterol
level 1.5 times higher than the
average for a child in the population
being tested. Dr Wald explains: “The
first thing we would do then would be
to test the parents. One of them would
have to be affected, because it is a
genetic condition. We could offer the
parents immediate treatment.”
Treatment for a parent or a child
carrying the gene would most likely be
a cholesterol-lowering statin drug.
A study reported in August 2007 by
cardiologists at the University of
Amsterdam in the Netherlands had found
that early, long-term statin therapy
prevented artery damage in children
with familial hypercholesterolemia.
The study included 214 children who
were treated with statins for an
average of 4.5 years.
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