Title: Cholesterol
Category: Child Care
Should we be checking cholesterol levels on our pediatric patients? Some feel we should, others feel we should only screen high risk patients. In a recent pediatric study done by four pediatricians in a group practice in Houston, Texas, screening of over 15,000 children and adolescents did pick up a high percentage of high risk kids who were over the 90th percentile for expected cholesterol level. There was also a high correlation between siblings in the study. The feeling of the Houston doctors was that we need more age and sex specific reference values for cholesterol levels so that we can know exactly what the levels we screen mean. Also they felt strongly that special emphasis should be directed toward the siblings of children who already had high cholesterol. This is the general feeling of the American Academy of Pediatrics and as we learn more and more about cholesterol in children most pediatricians will probably screen the levels more and more in the future. Another study published in the August 1991 Pediatric Journal showed a very high correlation between smoking and abnormal cholesterol levels. In fact, the more passive exposure to smoke (in other words, if both parents smoked in a home) teenagers were found to have a much higher low density lipoprotein and lower high density lipoprotein level and a higher total cholesterol level. This is the exact opposite that we would like to see which would be low total cholesterol, high, high density lipoprotein and low, low density lipoprotein. This is another good reason for discouraging smoking in the home because of the effect it has on our growing children, particularly adolescents and the increased risk to their life for heart disease, even if they never smoke themselves. Perhaps we should be screening children in homes of smokers even more closely than children in homes of non-smokers for cholesterol levels.