# Lp(a)-spiegels bij kinderen met hypercholesterolemie: impact op LDL-C-interpretatie

*geplaatst 2026-02-24 · Cholesterol · European journal of preventive cardiology · doi 10.1093/eurjpc/zwag126 · https://hartvaat.nl/2026/02/24/lp-a-spiegels-bij-kinderen-met-hypercholesterolemie-impact-op-ldl-c-interpretati/*

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.

## English: Lipoprotein(a) levels in children with hypercholesterolemia.

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.

## Abstract (original, from the publication)

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.

Auteurs: Matej Mlinaric, Barbara Cugalj Kern, Ana Drole Torkar, Jaka Sikonja, Jan Kafol, Robert Sket, Tine Tesovnik, Jernej Kovac, Tadej Battelino, Urh Groselj

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Bron: European journal of preventive cardiology, https://doi.org/10.1093/eurjpc/zwag126. Bijgewerkt 2026-07-03T13:24:25Z. 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.