ROUTINE CHILDHOOD SCREENING FOR HYPERLIPIDEMIA IN ISRAEL

Screening of children and adolescents for hyperlipidemia is controvers ial. We performed a cholesterol surveillance study of 806 children age d between 6 and 14 years. The initial cholesterol screening test was d one by finger stick in the non-fasting state. Children with cholestero l values exceeding 4.55 mmol/l (''borderline'' risk) and their parents had their lipid profiles measured following a 12 h fast by venipunctu re, The incidence of coronary risk factors in the families of children with hypercholesterolemia was estimated. Of the initial group, 71 chi ldren had total capillary cholesterol levels greater than or equal to 4.55 mmol/l, and in 65 of these children serum lipid profile was reexa mined after an overnight fast. Fifty-five children were found to have total venous cholesterol (TVC) levels <4.55 mmol/l, and 27 of the 55 h ad a low density lipoprotein (LDL) cholesterol level >3.4 mmol/l (''bo rderline'' risk), A positive correlation was found between TVC and LDL -cholesterol levels. Of the hypercholesterolemic children 49% had a pa rent with hyperlipidemia and 13% had a family history of premature myo cardial infarction (before 55 years of age), We conclude that screenin g of children based on the presence of hypercholesterolemia or its pos sible complications in other family members may fail to identify many of the children with hypercholesterolemia. Thus, if thorough identific ation of young children with hypercholesterolemia is desired, inclusiv e population screening would be the most effective approach.