[II-JCKAP5-1-2] Assessment of LDL Cholesterol Levels and Non-Invasive Vascular Health in School-Aged Children: A Study in the Ogasa District, Shizuoka Prefecture.
キーワード：Familial Hypercholesterolemia, preventing lifestyle-related diseases, School-age screening
Aim: This study aimed to assess low-density lipoprotein cholesterol (LDL-C) levels in school-aged children, and to evaluate the utility of non-invasive vascular tests, FMD and IMT, in pediatric familial hypercholesterolemia (FH) patients.Method: We analyzed lipid test results from 8,568 students screened for preventing lifestyle-related diseases and 78 children under 15 years old with cholesterol levels exceeding 220 mg/dL who visited our hospital. We examined the LDL-C distribution from school-age screenings and conducted FMD and IMT assessments on those meeting the 2022 Pediatric FH Guidelines criteria.Results: Among the screened students, 186 (2.2%) exhibited LDL-C levels above 140 mg/dL, with 123 fourth graders (2.8%) and 63 first-year junior high students (1.5%) affected. The average LDL-C across all students was 90.0 mg/dL (SD: 21.3 mg/dL), with the 95th percentile at approximately 125.0 mg/dL. Of the 78 hospital-visited children, 65 met the FH diagnostic criteria. In children aged 10 or older, no significant IMT differences were observed between Definitive and Probable FH and Possible FH groups. However, a significant difference in FMD percentage was noted (9.9 [8.1-11.9] vs. 14.2 [11.6-16.3], P=0.003).Conclusions: Our findings highlight the LDL-C distribution in primary FH screening and suggest a potential reduction in FMD in pediatric FH patients aged 10 and older. These results emphasize the importance of initiating drug interventions in school-aged children to maintain optimal LDL-C levels for long-term cardiovascular health.