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Predictive value of family history in detecting hypercholesterolemia in predominantly Hispanic adolescents
R G Troxler1, M K Park, M A Miller
1Department of Pediatrics, University of Texas Health Science Center, San Antonio 78285.
Insights
Screening for high cholesterol in adolescents is crucial, as family history is an unreliable indicator. Hispanic teens showed lower high-density lipoprotein cholesterol levels, emphasizing the need for universal screening.
Area of Science:
- Cardiovascular Health
- Pediatric Endocrinology
Background:
- Hypercholesterolemia is a significant risk factor for premature coronary heart disease.
- Family history is often used to identify individuals at risk, but its predictive value may be limited.
Purpose of the Study:
- To assess plasma lipid levels in senior high school students.
- To compare lipid profiles between Hispanic and non-Hispanic adolescents.
- To evaluate the utility of family history in predicting hypercholesterolemia.
Main Methods:
- Blood samples were collected from 110 senior high school students.
- Plasma levels of total cholesterol, triglyceride, HDL-C, and LDL-C were measured.
- Results were analyzed in relation to family history of premature coronary heart disease or hypercholesterolemia.
Main Results:
- Hispanic adolescents had significantly lower high-density lipoprotein cholesterol (HDL-C) levels compared to non-Hispanics (P < 0.05).
- A positive family history was reported by 22% of students.
- Only 25% of students with high total cholesterol had a positive family history, yielding a positive predictive value of 38% for family history.
Conclusions:
- Family history alone is insufficient for identifying adolescents with hypercholesterolemia.
- Universal screening for hypercholesterolemia in adolescents is recommended, irrespective of family history.
- Targeted screening may miss at-risk individuals, particularly within specific ethnic groups like Hispanic adolescents.
Abstract:
Plasma levels of total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were obtained in 110 senior high school students who were predominantly Hispanic. Results were compared with family history of premature coronary heart disease or hypercholesterolemia. The level of high-density lipoprotein cholesterol was significantly lower in Hispanic adolescents than in non-Hispanics (P less than 0.05). A positive family history was found in 22% of the subjects. Only 25% of the students with high levels of total cholesterol had a positive family history. The positive predictive value of family history for a high level of total cholesterol was only 38%. These results suggest that adolescents should be screened for hypercholesterolemia regardless of a positive family history.