endocrine and metabolic disorders
Dyslipidemia
Screening for Dyslipidemia
Screening is done using a fasting lipid profile (TC, TGs, HDL-C, and calculated LDL-C). Medical society guidelines vary regarding when to begin screening. Based on the risk factors, screening can begin as early as age 2 in children with family history of heart disease or familial hypercholesterolemia. Lipid measurement should be accompanied by assessment for other cardiovascular risk factors, including Cigarette use Diabetes Mellitus (DM) None Family history of Overview of Coronary Artery Disease in a male first-degree relative before age 55 years or a female first-degree relative before age 65 years Hypertension None Most physicians recommend screening per the 2012 National Heart Lung and Blood Institute Guidelines ( Screening references ) as follows Children with risk factors (eg, Diabetes Mellitus in Children and Adolescents , Children with no risk factors: Non-fasting or fasting lipid profile once before puberty (usually age 9 to 11) and once more at age 17 to 21 Adults should be screened at age 20 ( Screening references ) and every 5 years thereafter. An age to discontinue screening has not been established, but evidence supports screening of patients into their 80s, especially if they have atherosclerotic cardiovascular disease ( Screening references ). Patients with an extensive family history of heart disease—heart attack, stroke, or coronary artery disease before age 55 (in men) or age 65 (in women) without known risk factors, such as high LDL, smoking, diabetes, or obesity, or known family history of high Lp(a)—should also be screened by measuring Lp(a) levels. 1.Expert Panel on Integrated Guidelinesfor Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents. 2011. 2.Goff DC Jr, Lloyd-Jones DM, Bennett G, et al: 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk.J Am Coll Cardiol63:2935–2959, 2014. doi: 10.1016/j.jacc.2013.11.005 3.Grundy SM, Stone NJ, Bailey AL, et al: 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation139: e1082–e1143, 2019. doi: 10.1161/CIR.0000000000000625 4.Kleipool EE, Dorresteijn JA, Smulders YM, et al: Treatment of hypercholesterolaemia in older adults calls for a patient-centred approach.Heart106(4):261-266, 2020. doi:10.1136/heartjnl-2019-315600 