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Endocrinology

North American Familial Chylomicronemia Score calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Age group and onset

Early onset means triglycerides of at least 5 mmol/L (440 mg/dL) in infancy or childhood. A child and an early-onset adolescent or adult each score 12, and those points are not added together. The score is not for infants under 1 year.

Body mass index

Adults use 25.0 kg/m². Children and adolescents use the 85th percentile. The lower category scores 9.

Secondary factors

No secondary factor scores 11. For age 10 years or older, the published scenarios assumed triglycerides had not fallen by 20% or more on a fibrate or high-dose omega-3 fatty acid.

Abdominal pain or pancreatitis
Fasting triglycerides

Severe elevation is above 10 mmol/L (880 mg/dL). That pattern scores 13.

Triglyceride to total cholesterol ratio

A high ratio scores 8. With low apolipoprotein B it adds 7 more. With no secondary factor it adds 5 more.

Apolipoprotein B

A low value scores 12. With a high triglyceride-to-cholesterol ratio it adds 7 more.

Result

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Clinical inputs

  • Age group and onset
  • Body mass index
  • Secondary factors
  • Abdominal pain or pancreatitis
  • Fasting triglycerides
  • Triglyceride to total cholesterol ratio
  • Apolipoprotein B

Primary source

Hegele RA et al. Development and validation of clinical criteria to identify familial chylomicronemia syndrome (FCS) in North America. J Clin Lipidol. DOI: 10.1016/j.jacl.2024.09.008. PMID: 39537503. Table 3 points, confirmed on the scenario grid in Table 2. Adolescent or adult with early hypertriglyceridemia onset 12. Child with hypertriglyceridemia 12. All fasting triglyceride readings severely elevated 13. High triglyceride/total cholesterol ratio 8. Low apolipoprotein B 12. BMI under 25.0 kg/m² in adults, or under the 85th percentile in children and adolescents, 9. Recurrent abdominal pain without pancreatitis 9. History of pancreatitis 16. No secondary factors 11. Interactions: high ratio and low apolipoprotein B 7; child and no secondary factors 7; high ratio and no secondary factors 5. Early onset is hypertriglyceridemia of at least 5 mmol/L (440 mg/dL) in infancy or childhood. Severe triglycerides are above 10 mmol/L (880 mg/dL) on all recent fasting samples. A high ratio is above 8 in mg/dL or above 3.5 in mmol/L. Low apolipoprotein B is under 1.0 g/L (100 mg/dL). In the validation, 60 or higher was definite classical FCS (specificity 100%, sensitivity 66.7%) and 45 or higher was likely FCS (specificity 96.9%, sensitivity 88.9%). (2024)

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