Azara Blog: Doctors want to give babies a cholesterol test

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Date published: 2007/09/14

The BBC says:

Children should receive a cholesterol test alongside their routine vaccinations at the age of 15 months, experts say.

The tests would identify those with an inherited cholesterol disorder which increases the risk of heart disease.

Parents of affected children would also be tested and treated, the British Medical Journal article states.

Various screening options, including DNA testing, are being considered by the government's health watchdog.

Familial hypercholesterolaemia is an inherited condition which affects about one in 500 people in which the body does not get rid of cholesterol in the usual way and it accumulates.

Adults aged 20-39 years with the condition have a 100-fold increased risk of dying from coronary heart disease.

But treatment with statins to lower cholesterol reduces the risk substantially.

A nationwide screening programme is being piloted in relatives of adults diagnosed with the familial hypercholesterolaemia but about four-fifths of people with the condition would not be found this way.

Analysis of 13 studies by researchers at Barts and the London Queen Mary's School of Medicine suggests testing children would identify most cases of the disorder.

Cholesterol tests in children between the age of one and nine years are the most accurate because as people get older their cholesterol gets higher for other reasons, such as an unhealthy diet, they say.

And the most obvious time to do the screening, which would involve a blood spot test, would be when children present for their routine vaccinations at 15 months.

For every child with the condition, one parent would also have to be affected and they could also be tested and treated.
The team are planning a pilot to assess feasibility and staff and parent acceptance.

The National Institute of Clinical Excellence is also looking at the issue and is due to report at the end of this year on what would be the best method for identifying those with the condition.

Dr Tony Wierzbecki, chairman of Heart UK's medical scientific and research committee, said in theory it was a good idea although tests were probably even more accurate in four to six year olds.

It's a reasonable enough idea but should only be done with parental approval (i.e. on a case by case basis). It should not be left up to doctors (or the government) what is deemed to be best for the world. And although the blood test will have been pointless for 499 out of 500 children for this specific disorder, once doctors have the blood sample one can imagine they will end up using it for lots of reasons, including adding every child to the national DNA database.

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