Updates in the management of pediatric dyslipidemia.

IF 3.8 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Current opinion in lipidology Pub Date : 2023-08-01 DOI:10.1097/MOL.0000000000000879

Pooja Choudhari, Nivedita Patni

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Abstract

Purpose of review: Pediatric dyslipidemias increase the risk of atherosclerosis and clinical cardiovascular disease and are the leading cause of morbidity and mortality. Lifestyle modifications and pharmacotherapies have measurably improved abnormal lipids and reduced cardiovascular events. The review will focus on current standards of care and investigative medications with the potential to improve cardiovascular health in children and adults.

Recent findings: Lifestyle interventions and statins remain cornerstones in the treatment of pediatric hyperlipidemias. Bile acid sequestrants and ezetimibe continue to be used in the pediatric population as well. In recent years, successful clinical trials have approved use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in children with familial hypercholesterolemia. Use of angiopoietin-like protein 3 (ANGPTL3) inhibitors is also promising as it causes marked improvement in low-density lipoprotein cholesterol with safe side effect profiles. Additional medications undergoing pediatric clinical trials include inclisiran, bempedoic acid, and lomitapide.

Summary: Recent advances in pharmacotherapy, especially for treatment of familial hypercholesterolemia, greatly impact treatment of dyslipidemias in children. Despite the overall progress in the development of these medications, therapies targeted towards treating hypertriglyceridemia have lagged behind. Continuing research for the treatment of pediatric dyslipidemias remains an important endeavor to reduce the risk of atherosclerosis and future cardiovascular events in children.

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儿童血脂异常管理的最新进展。

综述目的:儿童血脂异常增加动脉粥样硬化和临床心血管疾病的风险，是发病率和死亡率的主要原因。生活方式的改变和药物治疗明显改善了血脂异常，减少了心血管事件。该审查将侧重于目前的护理标准和具有改善儿童和成人心血管健康潜力的调查性药物。最新发现:生活方式干预和他汀类药物仍然是儿童高脂血症治疗的基石。胆汁酸隔离剂和依折麦布也继续在儿科人群中使用。近年来，成功的临床试验已经批准在家族性高胆固醇血症儿童中使用蛋白转化酶枯草杆菌素/酮素9型(PCSK9)抑制剂。血管生成素样蛋白3 (ANGPTL3)抑制剂的使用也很有希望，因为它可以显著改善低密度脂蛋白胆固醇，而且副作用安全。正在进行儿科临床试验的其他药物包括inclisiran、苯甲多酸和lomitapide。摘要:药物治疗的最新进展，特别是家族性高胆固醇血症的治疗，极大地影响了儿童血脂异常的治疗。尽管这些药物的发展取得了总体进展，但针对高甘油三酯血症的治疗却落后了。儿童血脂异常治疗的持续研究仍然是降低儿童动脉粥样硬化和未来心血管事件风险的重要努力。

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来源期刊

Current opinion in lipidology 医学-内分泌学与代谢

CiteScore

6.70

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： With its easy-to-digest reviews on important advances in world literature, Current Opinion in Lipidology offers expert evaluation on a wide range of topics from six key disciplines including nutrition and metabolism, genetics and molecular biology, and hyperlipidaemia and cardiovascular disease. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by a section of Bimonthly Updates, which deliver an insight into new developments at the cutting edge of the disciplines covered in the journal.