Supplementary key words cholesterol • dyslipidemias • genetics • genetic risk score • high density lipoprotein • low density lipoprotein • triglycerides CVD has reached epidemic proportions leading to 17.5 million deaths in 2012, which is 31% of the total mortality worldwide, making it the most common cause of death (1). Dyslipidemia is an important underlying risk factor. Specifically, increased serum levels of TGs, total cholesterol (TC), and LDL cholesterol (LDL-C), and decreased levels of HDL cholesterol (HDL-C) are associated with higher risk of coronary artery disease (CAD) (2-6). Statin therapy effectively reduces the risk of death from CAD by 20% (7).Family studies suggest that levels of blood lipids have a clear genetic component with heritability estimates for TGs, TC, LDL-C, and HDL-C of 48, 57, 59, and 52%, respectively (8). Large meta-analyses of genome-wide association studies (GWASs) performed in adults have identified 95, and more recently an additional 62 genetic loci associated with blood lipid levels, so that the total known loci now are 157 (9, 10). Much less is known about the genetic background of lipid levels in children. One GWAS was performed in a relatively small population of children, showing trends toward significance for a number of adult loci and one suggestive new locus (11). Another study found associations of genetic risk scores (GRSs) based on the 95 adult SNPs with lipid levels in children (12). Since then, the number of SNPs associated with lipid levels in adults has strongly increased and it is unknown whether the 157 currently known SNPs also have effects on the lipid concentrations in children. Serum lipid and lipoprotein levels show strong tracking from childhood to adulthood (13).Abstract Lipid concentrations are heritable traits. Recently, the number of known genetic loci associated with lipid levels in adults increased from 95 to 157. The effects of these 157 loci have not been tested in children. Considering that lipid levels track from childhood to adulthood, we studied to determine whether these variants already affected lipid concentrations in a large group of 2,645 children with a median age of 6.0 years (95% range 5.7-7.3 years) from the population-based Generation R Study. Twenty-eight SNPs associated with TGs, 39 SNPs associated with total cholesterol (TC), 28 SNPs associated with LDL cholesterol (LDL-C), and 56 SNPs associated with HDL cholesterol (HDL-C) were analyzed individually and combined into genetic risk scores (GRSs). All risk scores were associated with their specific outcomes. The differences in mean absolute lipid and lipoprotein values between the 10% of children with the highest lipid or lipoprotein GRS versus the 10% with the lowest score were 0.28, 0.25, 0.32, and 0.30 mmol/l for TGs, TC, LDL-C, and HDL-C, respectively. In conclusion, we show for the first time that GRSs based on 157 SNPs associated with adult lipid concentrations are associated with lipid levels in children. The genetic background of these phenotypes at least partly overlaps b...