lipid disorder in child – Symptoms, and treatments

Many studies have revealed that the early stages atherosclerosis begins in one’s childhood. If the early development of cardiovascular disease can be, predicted during childhood, the disease might as well be, prevented. The article is to discuss the various symptoms of lipid disorders and their treatment. There are a number of causes for lipids as vitamin D deficiency is one such problem.

Symptoms

Lipid disorders usually do not cause symptoms

In extreme cases however the following symptoms, may be found by medical history or physical exam:

  • Fatty deposits in the skin or tendons, caused by an excessive level of lipids in the blood.
  • Pain, extension, swelling of abdominal organs such as liver or pancreas due to excessively high levels of triglycerides in the blood.
  • Changes in blood vessels of the eye caused by elevated lipids.
  • All around the corner of the eye institute will get cholesterol deposits.
  • Vitamin D deficiency causes a lot of similar problems due to lipids.
  • The role of vitamin D is quite serious in this case.

A risk factor is something that increases the possibilities of acquiring some disease or condition.

Although a person who has a few risk factors is in a larger position to be, affected; anyone can develop this disease. There are several risk factors which increase the chances of lipid disorder.

  • Cholesterol level increases with age. In women, low-density lipoprotein (LDL) cholesterol levels often increase after menopause.

Other factors that may lead to an increase of lipid disorder.

A diet rich in saturated fat, trans fat, and cholesterol-

Eating food with high saturated fat, trans fat and cholesterol increase cholesterol levels. However dietary cholesterol doesn’t affect blood as much as salutary and trans fat does.

Sedentary lifestyle-

Proper exercise on a regular basis helps your body decrease unhealthy LDL cholesterol and increase healthy HDL cholesterol. Lack of exercise decreases the body’s capability to balance lipids.

Smoking-

Smoking causes a fall in the level of HDL, the healthy type of cholesterol, in the blood.

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Overweight and obesity-

Being overweight also causes cholesterol levels to strike up.

Hypothyroidism

An underactive thyroid can result in increased triglyceride and cholesterol levels.

Diabetes mellitus-

Diabetes is correlated with elevated triglyceride levels.

Metabolic syndrome-

This condition is, marked by, elevated blood pressure, cholesterol, blood glucose, and body weight. Too much of weight around the midsection is of particular concern.

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Liver disease-

Having, liver-related diseases can raise cholesterol level.

Kidney disease-

Some kidney diseases are linked to, elevated cholesterol and triglyceride levels.

Certain medication-

Many medications, including some antihypertensives, oral contraceptives, and steroids, can alter cholesterol levels. Consult your doctor to know if any of your medication is causing your cholesterol level to rise.

Dietary Treatment

A diet with <10% calories from saturated fat, 30% calories from fat, and <300 mg/day from cholesterol (AHA step I diet) is suggested for all healthy children ≥2 years of age. Consumption of polyunsaturated fats, monounsaturated fats, omega-3 fatty acids, and high -fiber foods should be promoted.

In case this is not successful in achieving cholesterol targets, a more strict diet plan, the AHA step II diet, is suggested.

Dairy saturated fat is reduced to <7% and dietary cholesterol to <200 mg/day, No unfavorable events have been recorded on growth, iron stores, nutrition or well being over a period of 3 to 10 years in children following a step II diet.

Lifestyle Treatment

Children should be encouraged to indulge in 60 minutes or more of rigorous play or aerobic activity per day. Sedentary time should be, reduced as possible, with a focus on reducing time spent on television, internet, and video games.

Tobacco and alcohol use should be highly, discouraged; eating disorders once spotted; should be, treated as early as possible.

Niacin

Niacin is the most potent HDL enhancer available today. It has, been used in small series of children  and is, recommended only as adjunctive therapy in children being, supervised by a lipid specialist

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Drug Treatment

Drug treatment may be necessary to achieve target LDL cholesterol. Pharmacological intervention, recommended in children ≥10 years with poor response to diet and lifestyle therapy, documented for at least 6-12 months. The choice of therapy, influenced by the lipid profile, age, gender and family history of the patient.

Recent guidelines have lowered the LDL cut-off levels for treatment and, promoted a more aggressive approach to pharmacological therapy of dyslipidemia in children. Early initiation of drug therapy, warranted in high-risk children and adolescents.

Dietary Supplements

Plant sterols and stanols can be, used in children while monitoring for effects on absorption of fat-soluble vitamins.

Omega-3 fatty acids and antioxidant vitamins can be, used in hyperlipidemic children but results are controversial. Some of the common sources of vitamin D, should be available to help fight such disease.

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In general, dietary supplements are not, encouraged as monotherapy in hyperlipidemic children.

Limitation of current guidelines

The current guidelines, described for screening and managing children and adolescents with dyslipidemia do have some limitations.

Screening, based on family history, which may not be available, or may not be accurate, in all cases. Percentile definitions do not take into account gender, race, ethnicity age, and pubertal status. Probably LDL levels alone, used to guide treatment and other risk factors/variables such as HDL cholesterol, non- HDL cholesterol, triglycerides, and apoprotein- B are not, taken into account.

in contrast the changes normally seen in lipid levels during childhood and adolescence are not, considered in these guidelines. Cholesterol levels are highest at age 9 to 11 years, decrease throughout adolescence, and increase later on. This temporal change may be, linked to the transient increase in insulin resistance at the onset of puberty.

Genetic counseling

Genetic counseling is required in families with familial hypercholesterolemia. They should be, explained the nature of the illness and its inheritance and the need for appropriate therapy. Effective genetic counseling helps in ensuring improved compliance with therapy and makes the patient an active partner in monitoring and therapy.

Conclusion

This review has tried to address the salient issues, related to screening and management of dyslipidemia in children. Most noteworthy, it will sensitize physicians and pediatricians to the need to correct this easily modifiable risk factor, so as to reduce the burden of disease and death in our future generations. Universal, and aggressive, use of the current guidelines is necessary to prevent future CVD.

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