Population-based screening in children for early diagnosis and treatment of familial hypercholesterolemia: design of the VRONI study

Med Genet. 2022 May 7;34(1):41-51. doi: 10.1515/medgen-2022-2115. eCollection 2022 Apr.

Abstract

Familial hypercholesterolemia (FH) is the most frequent monogenic disorder (prevalence 1:250) in the general population. Early diagnosis during childhood enables pre-emptive treatment, thus reducing the risk of severe atherosclerotic manifestations later in life. Nonetheless, FH screening programs are scarce. VRONI offers all children aged 5-14 years in Bavaria a FH screening in the context of regular pediatric visits. LDL-cholesterol (LDL-C) is measured centrally, followed by genetic analysis for FH if exceeding the age-specific 95th percentile (130 mg/dl, 3.34 mmol/l). Children with FH pathogenic variants are treated by specialized pediatricians and offered a FH-focused training course by a qualified training center. Reverse cascade screening is recommended for all first-degree relatives. VRONI aims to prove the feasibility of a population-based FH screening in children and to lay the foundation for a nationwide screening program.

Keywords: DigiMed Bayern; VRONI; atherosclerosis; familial hypercholesterolemia; hyperlipidemia; screening.

Grants and funding

Bavarian State Ministry of Health and Care funded this work within its framework of DigiMed Bayern (Grant No: DMB-1805-0001). The funding organization(s) played no role in the study design; in the collection, analysis, and Interpretation of data; in the writing of the report; or in the decision to submit the report for publication.