perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2026-71-2-7-17perinatology-2374Research ArticleПЕРЕДОВАЯEDITORIALРанняя диагностика и лечение гиперхолестеринемии у детей как залог снижения смертности от сердечно-сосудистой патологииEarly diagnosis and treatment of hypercholesterolemia in children as a key to reducing mortality from cardiovascular diseaseshttps://orcid.org/0000-0002-5273-6859ЛеонтьеваИ. В.Leont’evaI. V.

Леонтьева Ирина Викторовна — д.м.н., проф., глав.н.с. отдела детской кардиологии и аритмологии; проф. кафедры инновационной педиатрии и детской хирургии

125412, Москва, ул. Талдомская, д. 2 

125412, Moscow 

117513, Moscow 

lirina2006@mail.ruНаучно-исследовательский клинический институт педиатрии и детской хирургии имени академика Ю.Е. Вельтищева ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России ; ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияVeltischev Research and Clinical Institute for pediatrics and pediatric surgery at the Pirogov Russian National Research Medical University ; Pirogov Russian National Research Medical UniversityRussian Federation202625042026712717Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20262026Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/2374

Ишемическая болезнь сердца, возникающая на фоне коронарного атеросклероза, вносит наибольший вклад в структуру смертности от сердечно-сосудистой патологии. Истоки возникновения атеросклероза относятся к детскому возрасту. В статье представлены данные о распространенности, этиологии семейной гиперхолестеринемии, характеризующейся высоким уровнем холестерина липопротеинов низкой плотности, что приводит к началу атеросклеротического поражения сосудов уже в детском возрасте и развитию инфаркта миокарда на втором-третьем десятилетии жизни. Заболевание длительно протекает бессимптомно, особенно в детском возрасте, в связи с чем его выявление составляет менее 1% случаев. Изложены критерии диагностики и генетические аспекты заболевания, обсуждаются различные варианты скриннга на гиперхолестеринемию. Представлена стратегия первичной профилактики сердечно-сосудистой патологии, изложены современные возможности медикаментозной терапии. Представлены показания к назначению статинов, ингибитора всасывания холестерина, ингибиторов проконвертазы субтелизинкексина 9 типа (PCSK9). Обосновано, что раннее выявление семейной гиперхолестеринемии у детей будет способствовать, своевременному началу гиполипидемической терапии, что приостановит прогрессирование атеросклеротического процесса и будет профилактировать возникновение ишемической болезни сердца.

Coronary heart disease, which is caused by coronary atherosclerosis, is the largest contributor to cardiovascular mortality. Atherosclerosis originates in childhood. This article presents data on the prevalence and etiology of familial hypercholesterolemia, characterized by high levels of low-density lipoprotein cholesterol. This leads to the onset of atherosclerotic vascular disease in childhood and the development of myocardial infarction in the second or third decade of life. The disease is asymptomatic for a long time, especially in childhood, and therefore its detection rate is less than 1%. Diagnostic criteria and genetic aspects of the disease are outlined, and various screening options for hypercholesterolemia are discussed. A strategy for the primary prevention of cardiovascular disease is presented, and current drug therapy options are discussed. Indications for the use of statins, cholesterol absorption inhibitors, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are presented. It is demonstrated that early detection of familial hypercholesterolemia in children will facilitate the timely initiation of lipid-lowering therapy, which will halt the progression of atherosclerosis and prevent the development of coronary heart disease.

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The authors declare that there are no conflicts of interest present.