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Cholesterol Screening or Testing

What is cholesterol?

Cholesterol is a type of fat in the blood. It is needed for building hormones and cells. Everyone needs to have some cholesterol in their blood. What you eat affects the level of cholesterol in our blood. Cholesterol comes from animal products such as meat, eggs, and dairy products. If you eat less cholesterol and saturated fat, you will have less cholesterol in your blood.

Cholesterol has several parts: high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides. HDL is called the "good" cholesterol because it carries cholesterol away from the arteries to the liver. The liver helps the body get rid of cholesterol. The LDL is called "bad" cholesterol. If you have too much LDL, cholesterol builds up in the arteries. As a result your arteries become clogged. The HDL, LDL, and triglycerides together are called "total cholesterol."

Why is having low cholesterol important?

People who have higher-than-normal levels of cholesterol have a higher risk of developing clogged or narrowed blood vessels that carry blood to the heart muscle. Lower cholesterol levels can reduce the risk of heart disease.

Reducing children's cholesterol levels with proper diet and exercise gives children a better chance of having low cholesterol when they are adults.

What are normal and abnormal cholesterol levels?

Cholesterol levels for children are as follows:

               Total            LDL            HDL
            Cholesterol     Cholesterol    Cholesterol

Normal         <170            <100           >60
Borderline    170-200         100-130        40-60
Abnormal       >200            >130           <40

Should children have their cholesterol checked?

The normal diet of children younger than 2 years is high in fat and cholesterol. It is not helpful to test children younger than 2 years. Cholesterol levels of children may be checked between the ages of 2 and 5 years old, when they start kindergarten. Children who are at high risk for heart disease should be screened soon after they are 2 years old.

A child is at high risk of developing heart disease as an adult if family members have high blood cholesterol or early heart disease. Early heart disease includes heart attack, angina (chest pain), stroke, or bypass surgery in men less than 50 years old or women less than 60 years old. Information about grandparents is important because other relatives might not yet be old enough to have developed heart disease.

Doctors do not always agree on when to check the cholesterol levels of children who are not high risk. Testing all children is costly and only about half of children with high cholesterol levels will have high cholesterol as adults. Healthy diets and good exercise habits can be started for all children without knowing their cholesterol levels.

How often should my child's cholesterol be checked?

If your child's cholesterol is borderline high or abnormal, it will be checked again 1 to 2 weeks after the first test. Cholesterol levels vary somewhat day to day.

Children with total cholesterol greater than 200 will have a lipid profile or panel. This test measures the levels of LDL, HDL, and triglycerides, as well as total cholesterol. These levels will be checked again after 2 to 4 months of treatment.

If your child has a total cholesterol level between 170 and 199, treatment can start without the lipid panel. Your child's total cholesterol will probably be rechecked every year.

Children with total cholesterol below 170 do not need cholesterol to be checked again until they are teens. Most health care providers check the total cholesterol level of adults every 5 years as long as it remains in the normal range.

Lipid panels are not done for all children because it requires fasting for at least 12 hours. Lipid panels also cost much more than the total cholesterol test. In addition, the lipid panel requires blood drawn from a vein, a more difficult procedure than pricking a finger.

Should my whole family be checked?

If your child has very high cholesterol, everyone in your family should have their total cholesterol checked. It is helpful to start the whole family on a healthier diet and exercise program.

Written by B.D. Schmitt, M.D.
Published by McKesson Provider Technologies.
Last modified: 2006-10-27
Last reviewed: 2006-02-06
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
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