目的:家族性高胆固醇血症(FH)导致低密度脂蛋白胆固醇水平升高,这增加了过早发生动脉粥样硬化性心血管疾病(ASCVD)的风险。由于动脉壁的首次功能和形态变化发生在儿童时期,治疗应在儿童早期开始,以减轻ASCVD的升高风险.儿科医生在FH患儿的检测和护理中起着重要作用。在这项研究中,我们的目标是探索荷兰儿科医生在FH护理方面的潜在差距,以提高他们对FH患儿的认识和认识。
方法:匿名在线调查,使用GoogleForms部署,荷兰儿科学协会通过通讯分发了26个关于儿童FH护理的封闭式和半封闭式问题,大多数荷兰执业儿科医生都订阅了该通讯。此外,我们要求荷兰所有荷兰医院的儿科部门在其雇用的儿科医生中亲自分发这项调查。受访者被指示在没有任何帮助或使用在线资源的情况下回答问题。
结果:9月1日之间,2023年和11月1日,2023年,158名(估计11%的反应率)荷兰儿科医生完成了调查。他们报告的儿科医生经验中位数(IQR)为15.0(6.0-22.0)年,34人(21.5%)在学术医院工作。大多数(76.6%)的儿科医生正确地确定了典型的FH血脂谱,但68(43.0%)低估了FH的真实患病率(1:300)。有37.3%和25.9%的儿科医生报告了对FH患者ASCVD风险增加的低估和认识,分别。尽管70.9%的儿科医生正确定义了FH,只有67例(42.4%)选择他汀类药物和依泽替米贝治疗重度高胆固醇血症.
结论:这项研究的结果表明,荷兰儿科医生对儿童FH的知识和认识存在显著差距。需要通过教育和培训举措来改善儿童的FH护理,以减轻早期ASCVD的终身风险。
背景:•家族性高胆固醇血症(FH)导致LDL-胆固醇水平升高,这增加了过早发生动脉粥样硬化性心血管疾病(ASCVD)的风险。•动脉粥样硬化的过程始于儿童期•儿科医生在FH儿童的检测和治疗中发挥重要作用。
背景:我们的研究结果突出了儿科医生在FH患儿护理方面的巨大差距,这可能导致检测和治疗欠佳。•儿童的FH护理需要通过教育举措来改善,以最终预防成年后的ASCVD。
OBJECTIVE: Familial hypercholesterolemia (FH) leads to elevated low-density lipoprotein cholesterol levels, which increases the risk of premature atherosclerotic cardiovascular disease (ASCVD). Since the first functional and morphologic changes of the arterial wall occur in childhood, treatment should start early in childhood to mitigate the elevated risk of ASCVD. Pediatricians play an important role in the detection and care of children with FH. In this study, we aim to explore potential
gaps in FH care amongst Dutch pediatricians, in order to enhance their knowledge and awareness of detecting and treating children with FH.
METHODS: An anonymous online survey, deployed using Google Forms, including 26 closed and semi-closed questions on FH care in children was distributed by the Dutch Association of Pediatrics via a newsletter to which the majority of the practicing Dutch pediatricians subscribe. In addition, we requested that the pediatric departments of all Dutch hospitals in the Netherlands distribute this survey personally among their employed pediatricians. Respondents were instructed to answer the questions without any help or use of online resources.
RESULTS: Between September 1st, 2023 and November 1st, 2023, 158 (an estimated 11% response rate) Dutch pediatricians completed the survey. They reported a median (IQR) of 15.0 (6.0-22.0) years of experience as a pediatrician, and 34 (21.5%) were working in academic hospitals. The majority (76.6%) of pediatricians correctly identified a typical FH lipid profile but 68 (43.0%) underestimated the true prevalence of FH (1:300). Underestimation and unawareness of the increased risk of FH patients for ASCVD were reported by 37.3% and 25.9% of pediatricians, respectively. Although 70.9% of the pediatricians correctly defined FH, only 67 (42.4%) selected statins and ezetimibe to treat severe hypercholesterolemia.
CONCLUSIONS: The results of this study suggest significant
gaps in knowledge and awareness of FH in children among Dutch pediatricians. FH care in children needs improvement through educational and training initiatives to mitigate the life-long risk of ASCVD from early life.
BACKGROUND: • Familial hypercholesterolemia (FH) leads to elevated LDL-cholesterol levels, which increases the risk of premature atherosclerotic cardiovascular disease (ASCVD). • The process of atherosclerosis starts in childhood • Pediatricians play an important role in the detection and treatment of children with FH.
BACKGROUND: • Our results highlight significant
gaps in care for children with FH amongst pediatricians and this may lead to suboptimal detection and treatment. • FH care in children needs improvement by educational initiatives to ultimately prevent ASCVD in adulthood.