Rushika Conroy has published a book chapter in her field of pediatric endocrinology, entitled: Disorders of Lipid Metabolism, in the textbook of pediatric Endocrinology. A summary of the chapter and citation are noted below.
Cardiovascular disease is typically thought of as an adult disorder; however, its predecessor, atherosclerosis, typically begins during childhood. An abnormal lipid profile is one contributing factor to atherosclerosis that may increase the risk of future premature cardiovascular events. Normal lipid physiology is based on lipid production and metabolism. Metabolism occurs by three interconnected pathways: exogenous, endogenous and reverse cholesterol transport. Abnormalities in these processes result in lipid disorders, which can be acquired or genetic. Acquired lipid disorders are secondary to etiologies such as obesity, type 1 and 2 diabetes, metabolic syndrome, or chronic renal failure. Genetic mutations are inherited abnormalities that in some cases, such as heterozygous familial hypercholesterolemia, have been shown to cause abnormal changes in lipid profiles, endothelial dysfunction and carotid intima thickness as early as infancy.
In 2011 the National Heart, Lung, and Blood Institute (NHLBI) released new controversial screening guidelines for non-fasting cholesterol levels in all children at 9-11 years old and again at 17-21 years old in order to identify genetic and acquired causes of lipid disorders. With an estimate of 21% of children and adolescents in the United States having high total cholesterol, low HDL cholesterol, or high non-HDL cholesterol , screening allows for identification of both mild abnormalities treated with lifestyle modification as well as more severe hyperlipidemia requiring both dietary and pharmacologic management. The chapter reviews the diagnosis, presentation and management of disorders of HDL, LDL, and triglyceride metabolism.