Usefulness of serum apolipoprotein B levels for screening children with primary dyslipoproteinemias
A. Sarria, L. A. Moreno, M. Mur, A. Lazaro and M. Bueno
Department of Pediatrics, Hospital Clinico Universitario, Lozano Blesa, Zaragoza, Spain.
OBJECTIVE--To assess the use of serum apolipoprotein B levels for screening
children with primary dyslipoproteinemia (those with elevated levels of
low-density lipoprotein cholesterol [LDL-C]) and to know the types of
dyslipoproteinemias we can identify. DESIGN--Criterion standard.
SETTING--Referral center. PARTICIPANTS--We have studied 267 children. Of
these, 31 had parents with dyslipoproteinemia, 38 had parents with ischemic
heart disease, and 43 had hypercholesterolemia detected by routine
analyses. One hundred fifty-five were considered healthy children and
comprised the control group. INTERVENTIONS--None. MEASUREMENTS AND MAIN
RESULTS--Sensitivity was 87% for total serum cholesterol levels and 73% for
serum apolipoprotein B levels. Of the children studied, 31 had elevated
levels of serum LDL-C. The types of dyslipoproteinemia in children with
both elevated levels of serum LDL-C and apolipoprotein B consisted of
heterozygous familial hypercholesterolemia, found in 12 (50%) of 24
patients; familial combined hyperlipidemia, found in 11 (46%) of 24
patients; and polygenic hypercholesterolemia, found in one (4%) of 24
patients. CONCLUSIONS--Serum apolipoprotein B level appears to be a good
tool for screening children with elevated levels of LDL-C and is equivalent
to using total serum cholesterol levels. In children with elevated serum
LDL-C and apolipoprotein B levels, we can identify not only patients with
heterozygous familial hypercholesterolemia but also those with familial
combined hyperlipidemia or polygenic hypercholesterolemia.
