David M. Diamond et al. Uffe Ravnskov Michel de Lorgeril
In their meta-analysis Radaelli et al. conclude that statin treatment is efficient in lowering lipids in children with familial hypercholesterolemia (FH) and suggest that long-term trials should be performed to establish long-term safety. We would warn against their recommendation for several reasons.
As we have shown in a recent paper, there is much evidence that high LDL-cholesterol (LDL-C) is not the cause of premature coronary heart disease in FH; it is most likely inborn abnormal coagulation factors, and only a small minority among those with FH inherits these factors. On average, people with FH live just as long as other people because high LDL-C protects against cancer and infectious diseases. Furthermore, to treat children with statins may ultimately cause them harm because cholesterol is necessary for the developing brain and is an essential precursor for metabolic co-factors and hormones, including vitamin D and all sex steroids.
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