This JCL Roundtable discussion probes the knowledge of 3 experts in pediatric lipidology, an emerging discipline both in the United States and internationally. In the 1990s, only 3 US institutions could be said to have dedicated pediatric lipid clinics; that number has grown to 25 today. The Pediatric Atherosclerosis Prevention and Lipidology Group of the National Lipid Association has regular teleconferences to support advocacy and convey best practices. Guidelines for pediatric lipidology initially focused on low-density lipoprotein cholesterol in 1992 as part of the National Cholesterol Education Program. Today the most comprehensive coverage comes from the 2011 National Heart Lung and Blood Institute Pediatric Guidelines. Universal screening was recommended for children between ages 9 and 11 years and teenagers/young adults between 17 to 21 years, a position echoed as “may be recommended” by the 2018 AHA/ACC/Multisociety Cholesterol Guidelines. While pediatric lipidologists continue to treat uncommon genetic disorders, they increasingly confront an issue of epidemic proportions—dyslipidemia as the initial presentation of metabolic dysregulation associated with obesity. Consequences of such altered metabolism extend to atherosclerosis, diabetes, liver disease, and other serious problems in adult life. Pediatric lipid science and practice differ from adult experience in several ways, including importance of family and birth history as well as genetics/epigenetics, lack of general pediatricians’ familiarity with lipid drugs, value of family counseling, need for biomarkers of early metabolic dysregulation, and anticipation of endpoints in adult life not fully defined by randomized clinical trials in children.

这次JCL圆桌讨论会探讨了3位儿科脂质学专家的知识，这是美国和国际上新兴的学科。在1990年代，可以说只有3家美国机构设有专门的儿科脂质诊所；今天这个数字已经增加到25。国家脂质协会的小儿动脉粥样硬化预防和脂质学小组定期举行电话会议，以支持倡导并传达最佳做法。作为国家胆固醇教育计划的一部分，儿科脂质学指南最初于1992年侧重于低密度脂蛋白胆固醇。今天，最全面的报道来自《 2011年美国国家心肺与血液研究所儿科指南》。建议对9至11​​岁的儿童和17至21岁的青少年/年轻人进行通用筛查，这一立场在《 2018年美国心脏协会/ ACC /多胆固醇胆固醇指南》中被“推荐”。虽然儿科脂质学家继续治疗罕见的遗传疾病，但他们越来越面临流行病的问题-血脂异常是与肥胖症相关的代谢异常的最初表现。这种代谢改变的后果扩展到动脉粥样硬化，糖尿病，肝病和成人生活中的其他严重问题。儿科脂质科学和实践与成人经历在几个方面有所不同，包括家庭和出生史以及遗传学/表观遗传学的重要性，普通儿科医生对脂质药物的不熟悉，家庭咨询的价值，