Prevention & lipidsCross-sectional study

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

LancetPublished

  • Cross-sectional study
  • international registry (Familial Hypercholesterolaemia Studies Collaboration (FHSC))
  • 55 regional or national registries in 48 countries

Authors' conclusion

Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation.

Study context

Population
Children and adolescents <18 years with clinical or genetic diagnosis of heterozygous familial hypercholesterolaemia (HeFH) at entry into the FHSC registry, Oct 2015–Jan 2021
Participants
11,848 children · 55 registries · 48 countries
Outcome
Current identification and management of children and adolescents with familial hypercholesterolaemia

Main finding

As reported in the abstract

Median age at registry entry
9.6 years (IQR 5.8-13.2)
Genetically confirmed diagnosis
10 099 (89.9%) of 11 235
Clinical diagnosis
1136 (10.1%)
Genetic diagnosis, high-income countries
9427 [92.4%] of 10 202
Genetic diagnosis, non-high-income countries
199 [48.0%] of 415
Index cases
3414 (31.6%) of 10 804
Not taking lipid-lowering medication (LLM)
7557 (72.4%) of 10 428
LDL-C in those not taking LLM, median
5.00 mmol/L (IQR 4.05-6.08)
Unadapted adult clinical criteria vs genetic diagnosis could miss children and adolescents with FH
50-75%

Observational data: associations, not effects.

Original publication

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study. Lancet. Published 12 December 2023. doi:10.1016/s0140-6736(23)01842-1

Summarised from the published abstract; every number is checked against it