Prevention & lipidsMeta-analysis
Screening for Lipid Disorders in Children and Adolescents
- Systematic review and meta-analysis
- random-effects meta-analysis
Authors' conclusion
No direct evidence on the benefits or harms of pediatric lipid screening was identified. While multifactorial dyslipidemia is common, no evidence was found that treatment is effective for this condition. In contrast, FH is relatively rare; evidence shows that statins reduce lipid levels in children with FH, and observational studies suggest that such treatment has long-term benefit for this condition.
Study context
- Population
- Children and adolescents with familial hypercholesterolemia (FH) or multifactorial dyslipidemia
- Participants
- 491,516 children · 43 studies
- Comparison
- Lipid screening and treatment of pediatric dyslipidemia (statins, nonstatin drugs, behavioral counseling) vs placebo or control
- Outcome
- Health outcomes, diagnostic yield, intermediate outcomes, behavioral outcomes, and harms
Pooled result
As reported in the abstract
- Prevalence of phenotypically defined FH (3 US studies, n = 395 465)
- 0.2% to 0.4% (1:250 to 1:500)
- Prevalence of elevated total cholesterol (≥200 mg/dL) (5 studies, n = 142 257)
- 7.1% to 9.4%
- Prevalence of any lipid abnormality
- 19.2%
- Statins vs placebo in FH (10 randomized clinical trials (RCTs), n = 1230): greater mean reduction in total cholesterol and LDL-C at up to 2 years
- 81- to 82-mg/dL
- Behavioral counseling in multifactorial dyslipidemia (2 trials, n = 934): greater total cholesterol reduction vs control; not persistent at longest follow-up
- 3- to 6-mg/dL
Safety
Harms in short-term drug trials
- Similar in the intervention and control groups
Original publication
Screening for Lipid Disorders in Children and Adolescents. JAMA. Published 18 July 2023. doi:10.1001/jama.2023.8867
Summarised from the published abstract; every number is checked against it