Our objective was to compare serum lipid profiles, total cholesterol (TC), low-density lipoprotein (LDL), triglycerides (TG), and high-density lipoprotein (HDL) between children with Down syndrome (DS) and their non-DS siblings. We hypothesized that the children with DS would have higher TC, LDL, and TG and lower HDL. The secondary aim was to explore if the difference in lipid profiles could be explained by differences in weight status.


This was a cross-sectional study. Fasting lipid profile was obtained from 27 children with DS and 31 siblings between 4 and 10 years of age with no severe comorbidities (heart disease, cancer, hypothyroidism, diabetes, or obesity). BMI was calculated and BMI z scores were used to account for differences in BMI throughout childhood.


Children with DS had higher TC (difference, 11.2 mg/dL; 95% confidence interval: 2.5–19.9; P = .01), LDL (12.8 mg/dL; 7.2–18.4; P < .001), TG (33.6 mg/dL; 11.1–56.1; P = .003), and lower HDL (−7.6 mg/dL; −12.1 to −3.0; P = .001) after adjustment for race, gender, age, and ethnicity. Results remained significant after additional adjustment for BMI z score: TC (14.9 mg/dL; 4.9–24.9; P = .003), LDL (16.6 mg/dL; 10.1–23.2; P < .001), TG (32.7 mg/dL; 7.7–57.7; P = .01), and lower HDL (−6.4 mg/dL; −12.2 to −0.7; P = .03).


Children with DS have less favorable lipid profiles than their siblings independent of weight status. These findings may have important implications for the screening and treatment of this large population at increased risk for ischemic heart disease.

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