Dyslipidemia and lipoprotein(a) elevation. Prevention of atherosclerotic disease

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

We report the case of an obese female adolescent aged 13 years with a waist circumference at the 90th percentile and borderline blood pressure values, who attended a routine primary care visit. The salient finding of the anamnesis was a maternal history of ischemic stroke. Laboratory testing revealed marked elevation of Lp(a) together with mildly elevated LDL cholesterol, with the remainder of the lipid profile and glycemic parameters within normal limits. Given these findings, we reinforced lifestyle and dietary measures and arranged joint follow-up with pediatric endocrinology.

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.