儿童青少年脂质异常血症早期预防与成人期心血管健康

Early prevention of dyslipidemia in children and adolescents as well as cardiovascular health in adulthood

心血管疾病(CVD)已成为我国城市和乡村人群的第一位死亡原因,脂质代谢紊乱在动脉粥样硬化(AS)和CVD独立危险因素中居首要地位。大量研究表明AS相关性CVD其AS病灶却在儿童早期即已存在,并且这个过程与升高的血浆胆固醇水平相关,我国儿童青少年脂质异常血症发生率呈上升趋势。本文介绍了儿童青少年脂质异常血症定义、最新分型、诊断及管理。一级预防强调遗传咨询、降低健康与疾病的发育起源理论相关因素对胎儿及子代产生的不良影响与生活方式预防。二级预防强调筛查的重要性,主张对具有高中风险和/或有阳性家族史的患儿进行脂质异常血症的筛查。三级预防即对中-重度脂质异常血症患儿进行严格饮食控制与药物干预,建议转诊专科医生多学科团队。最后介绍了儿童青少年脂质异常血症早期预防与成人期心血管健康研究进展。

In our country,cardiovascular disease(CVD)now ranks the first among independent risk factors for atherosclerosis(AS)and CVD,and it is now the leading cause of mortality in both urban and rural populations.Numerous studies have demonstrated that AS-related CVD begins with AS lesions in early childhood,and this process is correlated with increased plasma cholesterol levels.The prevalence of dyslipidemia among children and adolescents is increasing in China.The definition,latest categorization,diagnosis,and treatment of dyslipidemia in children and adolescents are presented in this article.Primary prevention places a focus on lifestyle prevention,genetic counseling,and avoiding harmful impacts of variables connected to the developmental genesis hypothesis of health and illness on fetuses and offspring.When it comes to secondary prevention,the focus is on the value of screening and the promotion of dyslipidemia screening in children at high/medium risk or with a positive family history.For children with moderate to severe dyslipidemia,tertiary prevention means careful dietary restriction and medication intervention.It is advised to refer patients to a multidisciplinary team of experts in tertiary prevention.Finally,the development of researches on adult cardiovascular health and early dyslipidemia prevention in children and adolescents is presented.