Čes-slov Pediat 2026, 81(88):13-19

Diagnostic and therapeutic recommendations for dyslipidemia in children and adolescents with obesity

Irena Aldhoon Hainerová¹, Pavel Ješina², Michal Vrablík³

¹ Klinika dětí a dorostu, 3. lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Královské Vinohrady, Praha

² Metabolické centrum, Klinika pediatrie a dědičných poruch metabolismu, Všeobecná fakultní nemocnice, Praha

³ Centrum preventivní kardiologie, III. interní klinika, 1. lékařská fakulta, Univerzita Karlova a Všeobecná fakultní nemocnice, Praha

Dyslipidemia represents a significant risk factor for the development of atherosclerotic cardiovascular disease in children and adolescents with obesity. Atherosclerotic changes begin in childhood, making early diagnosis and intervention crucial. The prevalence of dyslipidemia

is several times higher in children with overweight or obesity compared with those of normal body weight. The etiology of dyslipidemia can be primary, genetically determined-such as familial hypercholesterolemia or combined hyperlipidemias-or secondary, associated with obesity, insulin resistance, diabetes, or other conditions. In children with obesity, mixed etiology

is common, where genetic predisposition often amplifies the effects of an unhealthy lifestyle. Diagnosis includes medical history, physical examination, and lipid testing, preferably in the fasting state. Screening for familial hypercholesterolemia is part of routine pediatric preventive check-ups in at-risk individuals

Treatment begins with lifestyle interventions, including dietary modification, increased physical activity, and reduction of sedentary behavior

If non-pharmacological interventions fail, pharmacotherapy may be considered, particularly statins, which effectively lower low-density lipoprotein cholesterol and overall cardiovascular risk. Novel anti-obesity medications, such as glucagon-like peptide-1 receptor

agonists, can support weight management and improve the lipid profile. This article focuses specifically on the diagnosis and management of dyslipidemia in children with obesity and does not cover genetically determined lipid disorders, which require specialist care in lipid metabolism.

It should be noted that precise treatment protocols and international consensus for this patient group are still lacking. Therefore, in preparing this text, we drew on existing recommendations for other high-risk pediatric populations, such as children with diabetes, and partly also for those with genetically determined forms of dyslipidemia.

Keywords: dyslipidemie, obezita, léčba, děti, kardiovaskulární onemocnění, statiny, antiobezitika

Accepted: March 31, 2026; Published: March 1, 2026  Show citation