Management of the dyslipidemia in children and adolescents

Cardiovascular diseases are one of the most common causes of disability and mortality in the young working age population worldwide. Atherosclerosis is a key pathological process that leads to early cardiovascular catastrophes, including heart attacks, strokes and ischemic heart disease. Timely diagnosis of dyslipidemia can ensure the initiation of effective treatment and prevention. Hereditary forms of lipid metabolism disorders are particularly dangerous and require close attention, starting from childhood. One of the effective methods for diagnosing dyslipidemia is screening of blood cholesterol levels. The world practice includes several types of screening, but the most commonly used are selective and universal. In the Russian Federation, until now, measurement of cholesterol levels has not been included in any examination of a child as part of dispensary monitoring. The new resolution pays special attention to children from risk groups and the measurement of total cholesterol from capillary blood at the ages of 6 and 10 years.

1. Vaduganathan M., Mensah G.A., Turco J.V., Fuster V., Roth G.A. The global burden of cardiovascular diseases and risk: A compass for future health. J Am Coll Cardiol. 2022; 80(25): 2361–2371. DOI: 10.1016/j.jacc.2022.11.005

2. Gujral J., Gupta J. Pediatric Dyslipidemia. StatPearls Publishing. 2025. https://www.ncbi.nlm.nih.gov/books/NBK585106/#article-136349.s4

3. Garg A., Radhakrishnan S. Pediatric hyperlipidemia. Indian Heart J. 2024; 76(1): S104–S107. DOI: 10.1016/j.ihj.2023.11.269

4. Mainieri F., La Bella S., Chiarelli F. Hyperlipidemia and cardiovascular risk in children and adolescents. Biomedicines 2023; 11(3): 809. DOI: 10.3390/biomedicines11030809

5. Pederiva C., Capra M.E., Viggiano C., Rovelli V., Giuseppe B., Biasucci G. Early prevention of atherosclerosis: Detection and management of hypercholesterolaemia in children and adolescents. Life (Basel). 2021; 11(4): 345. DOI: 10.3390/life11040345

6. Harada-Shiba M., Ohtake A., Sugiyama D., Tada H., Dobashi K., Matsuki K. et al. Guidelines for the diagnosis and treatment of pediatric familial hypercholesterolemia 2022. J Atheroscler Thromb. 2023; 30(5): 531–557. DOI: 10.5551/jat.CR006

7. Nielsen T.R.H., Lausten-Thomsen U., Fonvig C.E., Bojsoe C., Ledersen L., Bratholm P.S. et al. Dyslipidemia and reference values for fasting plasma lipid concentrations in Danish/North-European White children and adolescents. BMC Pediatr. 2017;17(1):116. DOI: 10.1186/s12887-017-0868-y

8. Sapunar J., Aguilar-Farías N., Navarro J. Araneda G., Chandia-Poblete D., Manriquez V. et al. High prevalence of dyslipidemia and high atherogenic index of plasma in children and adolescents. Rev Med Chil. 2018; 146(10): 1112–1122 DOI: 10.4067/S0034-98872018001001112

9. Vasyukova O.V., Okorokov P.L., Malievskiy O.A., Nejmark A.E., Zorin E.A., Yashkov Yu.I. et al. Clinical guidelines “Obesity in children”. Ozhirenie I metabolism. 2024; 21(4): ь439–453 (in Russ)] DOI:10.14341/omet13194

10. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011; 128(5): S213–S256. DOI: 10.1542/peds.2009-2107C

11. Ezhov M.V., Bazhan S.S., Ershova A.I., Meshko A.N., Sokolov A.A., Kuharchuk V.V. et al. Ateroskleroz i dislipidemii. Clinical guidelines for familial hypercholesterolemia. Ateroskleroz i dislipidemii. 2019; (1): 5–43 (in Russ)

12. Aleksandrov AA, Kislyak OA, Leontyeva IV. Clinical guidelines: diagnosis, treatment and prevention of arterial hypertension in children and adolescents. Sistemnye gipertenzii. 2020; 17(2): 7-35 (in Russ) DOI: 10.26442/2075082X.2020.2.200126

13. Fredrickson D.S., Levy R.I., Lees R.S. Fat transport in lipoproteins—an integrated approach to mechanisms and disorders. N Engl J Med. 1967; 276(5): 273–281. DOI: 10.1056/NEJM196702022760507

14. Levy R.I., Fredrickson D.S. Diagnosis and management of hyperlipoproteinemia. Am J Cardiol. 1968; 22(4): 576–583. DOI: 10.1016/0002-9149(68)90165-3

15. Sadykova D.I., Salakhova K.R., Galimova L.F., Slastnikova E.S., Haliullina Ch.D. Familial hypercholesterolemia in children: current state of the problem. Voprosy Sovremennoi Pediatrii. 2023; 22(3): 231–240 (In Russ.)] DOI: 10.15690/vsp.v22i3.2576

16. Mach F., Baigent C., Catapano A.L., Koskinas K.C., Casula M., Badimon L. et al. ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Eur Heart J. 2020; 41(1): 111–188. DOI: 10.1093/eurheartj/ehz455

17. Ariza M.J., Valdivielso P. Familial chylomicronemia syndrome in children: a diagnosis challenge. Transl Pediatr. 2022; 11(11): 1743–1747. DOI: 10.21037/tp-22-515

18. Javed Z., Gladstone P., Talwalkar P.G. et al. Familial chylomicronemia syndrome: An expert clinical review from the National Lipid Association. J Clin Lipidol. 2025. DOI: 10.1016/j.jacl.2025.03.013

19. Falko J.M. Familial chylomicronemia syndrome: A clinical guide for endocrinologists. Endocr Pract. 2018; 24(8): 756–763. DOI: 10.4158/EP-2018-0157

20. Elkins C., Fruh S., Jones L., Bydalek K. Clinical practice recommendations for pediatric dyslipidemia. J Pediatr Health Care. 2019; 33(4): 494–504. DOI: 10.1016/j.pedhc.2019.02.009

21. Valaiyapathi B., Sunil B., Ashraf A.P. Approach to hypertriglyceridemia in the pediatric population. Pediatr Rev. 2017; 38(9): 424–434. DOI: 10.1542/pir.2016-0138

22. Schefelker J.M., Peterson A.L. Screening and management of dyslipidemia in children and adolescents. J Clin Med. 2022; 11(21): 6479. DOI: 10.3390/jcm11216479

23. Groselj U., Kovac J., Sustar U., Mlinaric M., Fras Z., Podkrajsek K.T. et al. Universal screening for familial hypercholesterolemia in children: The Slovenian model and literature review. Atherosclerosis. 2018; 277: 383–391. DOI: 10.1016/j.atherosclerosis.2018.06.858

24. National Cholesterol Education Program (NCEP): highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics. 1992; 89(3): 495-501. PMID:1741227

25. Thajer A., Baumgartner M., Jorda A., Hallwirth U., Lischka J., Greber-Platzer S. A selective screening strategy performed in pre-school children and siblings to detect familial hypercholesterolemia. Children (Basel). 2022;9(5): 590. DOI:10.3390/children9050590

26. Sadykova D.I., Kamalova A.A., Rakhmaeva R.F., Makarova T.P., Mel'nikova Yu.S., Galimova L.F. et al. Regional experience in universal cholesterol screening among children. Farmateka. 2023; 30(4–5): 104–108 (in Russ)] DOI:10.18565/pharmateca.2023.4-5.104-108

27. Ministry of Health of the Russian Federation. Order of 14.04.2025 No. 211n “On approval of the procedure for minors to undergo preventive medical examinations, registration form No. 030-PO/u ‘Preventive medical examination card for minors’, the procedure for its maintenance, and the form of sectoral statistical observation No. 030-PO/o ‘Information on preventive medical examinations of minors’, and the procedure for its completion.” Registered 22.05.2025 No. 82300 (in Russ)] http://publication.pravo.gov.ru/document/0001202505230032

28. Leontyeva I.V. Modern strategy of diagnosis and treatment of children with heterozygous familial hypercholesterolemia. Rossiyskiy Vestnik Perinatologii i Pediatrii. 2020; 65(4): 27-40. (in Russ) DOI:10.21508/1027-4065-2020-65-4-27-40

29. Kislyak O.A., Leontyeva I.V., Starodubova A.V., Aleksandrov A.A., Bubnova M.G., Varaeva Yu.R. et al. Eurasian clinical guidelines for the prevention of cardiovascular diseases in childhood and adolescence (2023). Evrazijskij kardiologicheskij zhurnal. 2023; (3): 6-35 (in Russ)DOI:10.38109/2225-1685-2023-3-6-35