Improving Long-Term Outcomes of Youth With Lipid Abnormalities-Expanding the Role of Pediatric Endocrinologists.

CONTEXT: There is a disturbingly high prevalence of dyslipidemia in youth. Although pediatric endocrinologists are aware of the substantial cardiovascular (CV) risk associated with monogenic disorders of lipid and lipoprotein metabolism, relatively few recognize the CV disease (CVD)-related morbidity and premature mortality incurred by common endocrine disorders associated with dyslipidemia, such as diabetes mellitus, growth hormone deficiency, congenital adrenal hyperplasia, and hypopituitarism.

OBJECTIVE: In this article, we discuss the expanding role of pediatric endocrinologists in CV health and risk prevention.

DESIGN: We reviewed available literature and summarized discussions with opinion leaders in pediatric endocrinology to accomplish the following: (i) provide an overview of this timely topic; (ii) identify opportunities for targeted education; and (iii) discuss ways of expanding clinical services to improve outcomes.

RESULTS: In addition to well-known genetic disorders of lipid and lipoprotein metabolism, youth with common endocrine disorders, including type 1 and type 2 diabetes, would benefit from cholesterol screening and in some, early intervention, including use of lipid-lowering medications. Despite the growing need, the location and extent of services available to youth with dyslipidemia and the availability of providers with experience in treatment of dyslipidemia are largely unknown but likely inadequate to provide accessible, timely, and cost-effective intervention.

CONCLUSION: With a new awareness of opportunities to prevent premature CVD in youth, including those with common endocrine disorders and CVD-related events during adulthood, there is an urgent need for additional clinical services and targeted education of current as well as future pediatric endocrinologists.