In reaching this recommendation for early and universal screening to detect advanced or genetically determined hypercholesterolemia, the FNLA committee carefully considered the rationale for this timing of lipid measurement. The first consideration was that this age, 9 - 11 years, identifies those individuals with the potential onset of advanced atherosclerosis. This age also has the best discrimination between those with or without inherited dyslipidemias and avoids confounding by puberty-related changes in lipid levels. As children progress into the teenage years, other causes of significant cholesterol elevations impinge, especially environmental and behavioral factors that may be more important on the progress of the hypercholesterolemic condition than the pathologic processes themselves. The younger the child, the more an LDL level of 160 mg/dL will discriminate between children who do or do not have FH.
J Clin Lipidol. 2011; 5(6).