{"id":"980a40a8ed13","type":"article","url":"https://hartvaat.nl/2026/02/24/lp-a-spiegels-bij-kinderen-met-hypercholesterolemie-impact-op-ldl-c-interpretati/","title":"Lp(a)-spiegels bij kinderen met hypercholesterolemie: impact op LDL-C-interpretatie","title_en":"Lipoprotein(a) levels in children with hypercholesterolemia.","category":"cholesterol","category_label":"Cholesterol","professions":["huisarts","internist"],"tags":["cetp-remmers","dyslipidemie","ezetimibe","familiaire-hypercholesterolemie","familiaire-hypercholesterolemie-screening","ldl-cholesterol","lipide-aferese","lipidenverlaging","lipoproteïne-a","lipoproteïne-a-therapeutisch-doel","pelacarsen","statines"],"journal":"European journal of preventive cardiology","doi":"10.1093/eurjpc/zwag126","source_url":"https://doi.org/10.1093/eurjpc/zwag126","authors":["Matej Mlinaric","Barbara Cugalj Kern","Ana Drole Torkar","Jaka Sikonja","Jan Kafol","Robert Sket","Tine Tesovnik","Jernej Kovac","Tadej Battelino","Urh Groselj"],"significance":6,"published":"2026-02-24","source_date":"2026-02-24","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/hdl-functie-en-reverse-cholesterol/"],"congress":"","summary_en":"This study showed that lipoprotein(a) contributes substantially to measured LDL cholesterol in children with hypercholesterolemia, complicating the interpretation of lipid panels and potentially leading to overestimation of true LDL levels.","created":"2026-07-03T10:24:56Z","updated":"2026-07-03T13:24:25Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Bij kinderen met hypercholesterolemie blijkt lipoproteïne(a) een aanzienlijke bijdrage te leveren aan het gemeten LDL-cholesterol. Extreem hoge Lp(a)-waarden (circa 1 op 100 individuen) kunnen het LDL-C fors overschatten. De studie benadrukt het belang van Lp(a)-meting bij de evaluatie van kinderen met verhoogd cholesterol.","abstract_original":"AIMS: Lipoprotein(a) [Lp(a)] is a significant genetic risk factor for cardiovascular disease (CVD). Extremely high Lp(a) levels (153mg/dL), affecting about 1 in 100 individuals, can elevate low-density lipoprotein cholesterol (LDL-C) due to structural similarities between Lp(a) and LDL-C particles. This study assessed the role and impact of Lp(a) on LDL-C in children with hypercholesterolemia, a relationship that remains poorly understood. METHODS: The study included 1,418 children (median age: 6.34 years) with hypercholesterolemia, identified by universal or cascade familial hypercholesterolemia (FH) screening in Slovenia. Participants were categorized as: 363 (25.6%) with definite FH (pathogenic variants in LDLR/APOB/PCSK9), 1,014 (71.5%) with possible FH (no FH pathogenic variant), and 41 (2.9%) definite non-FH (siblings of definite FH cases without FH pathogenic variant). RESULTS: Elevated Lp(a) levels (>30 mg/dL) were found in 25.1% of definite FH and 34.9% of possible FH cases (p=0.003). In definite FH, 32.7% of Lp(a) levels contributed to LDL-C levels, and 18.6% of Lp(a) levels contributed to Apolipoprotein B. The Lp(a) component of LDL-C varied widely (0-49.6%) and accounted for 10.3% of LDL-C variability. After adjusting for Lp(a), elevated LDL-C (>3.5 mmol/L) still persisted in 88.4% of definite FH and 30.4% of possible FH children. CONCLUSIONS: One in four children with FH and one in three children with polygenic hypercholesterolemia have elevated Lp(a) levels, contributing notably to LDL-C levels and ApoB. Modifiable CVD risk factors (elevated LDL-C and obesity) are already present in those children, highlighting the need for early, targeted evaluation and management."}