OBJECTIVE: To study the changes of lipid trigone in children with a family history of coronary heart disease (CHD). METHODS: The concentrations of plasma low density lipoprotein cholesterol (LDL C), high density lipoprotein cholesterol (HDL C) and triglyceride (TG) were determined in 83 children with a family history of CHD and 83 normal controls. RESULTS: Compared with the controls, the levels of TG and LDL C, and the ratio of LDL C/HDL C were higher [( 1.46 ± 0.63 ) mmol/L vs ( 0.84 ± 0.43 ) mmol/L; ( 2.09 ± 1.13 ) mmol/L vs ( 0.96 ± 0.87 ) mmol/L; ( 1.71 ± 1.29 ) vs ( 0.96 ± 0.68 )], and the HDL C level was lower [( 1.48 ± 0.48 ) mmol/L vs ( 1.72 ± 0.53 ) mmol/L]in children with a family history of CHD (all P< 0.01 ). There was no difference in blood lipid trigone between boys and girls with a family history of CHD. The levels of TG and LDL C [( 1.86 ± 0.63 ) and ( 3.12 ± 1.32 ) mmol/L], and the ratio of LDL C/HDL C ( 2.85 ± 1.21 ) were higher in children with a family history of premature CHD than those in children with a family history of non premature CHD [( 1.34 ± 0.58 ) mmol/L, ( 1.79 ± 0.87 ) mmol/L, ( 1.37±1.11 ),[JP] respectively]; and the HDL C level was lower ; and the HDL C level was lower [( 1.11 ± 0.26 ) mmol vs ( 1.59 ± 0.47 )](all P< 0.01 ). The incidence of abnormal lipid trigone in children with a family history of premature CHD or non premature CHD and the controls were 52.6% , 10.9% and 1.2% , respectively. A significant difference was noted among the three groups (P< 0.01 ). CONCLUSIONS: Lipids metabolism is abnormal in children with a family history of CHD; and more remarkable disorders may be found in those with a family history of premature CHD. In children with a family history of CHD, abnormal lipid metabolism is an obvious high risk index for developing CHD in later life.