Lipoprotein (a) [Lp(a)] is a newly described risk factor for coronary heart disease (CHD). We hypothesized that in children already at risk for CHD due to high cholesterol, elevated Lp(a) would be associated with an even greater risk. Lp(a) and lipids were measured in 69 children referred for treatment of hyperlipidemia (40 White, 22 Hispanic, 5 Asian, 2 African-American; age 11± 4 yrs, mean ± SD). Family history (Fam Hx) of early CHD, defined as CHD in parents or grandparents before age 56 yrs, was used to estimate the child's CHD risk. Positive Fam Hx of early CHD was present in 27/69 children. Mean total cholesterol (TC) and LDL-C were higher in the children with positive versus negative Fam Hx, whereas Lp(a), HDL-C and triglycerides (mg/dl) were similar in the 2 groups. (t test and/or Mann-Whitney U test; values in mg/dl, mean ± SD).Table
Our results indicate that even in a group of hypercholesterolemic children those with positive Fam Hx have higher TC and LDL-C than those with negative Fam Hx. In contrast, Lp(a) levels, though generally high (mean 34.6 ± 30.2, range 1 - 140 mg/dl), did not identify the hyperlipidemic children with positive Fam Hx. Further study to define the role of Lp(a) in hyperlipidemic children is warranted.
