Dyslipidemia and lipoprotein A alteration. Prevention of atherosclerotic disease

Lipoprotein[Lp(a)] is an independent cardiovascular risk factor whose measurement in childhood is gaining relevance, particularly in patients with a family history of premature cerebrovascular disease and associated metabolic risk factors.

We report the case of a 13-year-old obese adolescent with a waist circumference at the 90th percentile and borderline blood pressure values, who attended a routine primary care visit. A maternal history of ischemic stroke was noted. Laboratory evaluation revealed a markedly elevated Lp(a) level and mildly increased LDL-cholesterol, while the remaining lipid profile and glycemic parameters were within normal ranges. Lifestyle interventions were reinforced and joint follow-up with pediatric endocrinology was planned.

This case highlights the importance of targeted Lp(a) screening in pediatric patients with cardiovascular risk factors, and the need for early intervention to optimize modifiable risk factors and reduce future atherosclerotic risk.