Diagnóstico precoce das dislipidemias em crianças e adolescentes e sua relação com fatores de risco cardiovasculares

Abstract

Childhood and adolescent dyslipidemias represent a major public health concern, acting as key determinants for the early development of atherosclerosis and cardiovascular diseases in adulthood. Therefore, this study aimed to evaluate lipid abnormalities in children and adolescents in order to understand their relationship with cardiovascular risk factors in adult life. An integrative literature review was conducted covering the period from 2015 to 2025 using the Scientific Electronic Library Online (SciELO), PubMed, and the Virtual Health Library (BVS) databases. Sixteen articles focusing on individuals aged 1 to 19 years were selected. Epidemiological data demonstrated a high prevalence of dyslipidemia during childhood, particularly highlighted by the ERICA study, which reported that 20.1% of Brazilian adolescents have hypercholesterolemia. Factors such as physical inactivity and the consumption of ultra-processed foods were strongly associated with obesity and an altered lipid profile. From a genetic perspective, familial hypercholesterolemia was identified as a major cause of critically elevated LDL-C levels from birth, emphasizing the importance of investigating family history. Regarding laboratory diagnosis, advances in calculation methods, such as the Martin equation, together with the elimination of fasting requirements in routine clinical practice, have made lipid screening more practical in the pediatric population while reinforcing the importance of non-HDL cholesterol and lipoprotein(a). Screening strategies included both universal screening at recommended ages and cascade screening for hereditary cases. Therapeutic management is primarily based on lifestyle modifications, with statins and ezetimibe reserved for high-risk patients. In conclusion, early laboratory diagnosis and lipid screening during childhood are essential for identifying lipid disorders and preventing the long-term development of atherosclerosis. Addressing this public health challenge requires coordinated efforts among governments, medical societies, and healthcare professionals to ensure early diagnosis and appropriate treatment. [resumo fornecido pelo autor]