[Identification of risk factors of hypercholesterolemia in children--9-year follow-up]

According to the hypothesis that atherosclerosis originates in childhood, it would be important for preventive purpose to identify and correct its risk factors among children, particularly hypercholesterolemia; 116 children belonging to a cohort of 556 children were found with total cholesterol level of greater than or equal to 200 mg/dl at least once during the first three years of life. These children at risk for hypercholesterolemia were followed up after nine years and compared with a control group of children having total cholesterol level of below 200 mg/dl and matched by sex and age. Both groups were submitted to a clinical examination, blood lipid determination, anthropometric measurements and were tested for food consumption. The average levels of total cholesterol (CT), triglycerides (TG), LDL-cholesterol, Apo B and CT/HDL-cholesterol (IA), Apo A/Apo B ratios were significantly higher among the children at risk, but HDL-cholesterol was lower. Forty per cent of children at risk had the CT level greater than or equal to 190 mg/dl in comparison with 15% of controls. The proportion of IA greater than or equal to 4.5 was 30% for the group at risk versus 8% for controls. The supra-iliac skinfold thickness was higher among the children at risk. Likewise the mothers of children at risk had higher weight and Quetelet index than the controls. The energy intake provided by the saturated fatty acids was higher for the group at risk, having a CT greater than or equal to 200 mg/dl. The intake of proteins, carbohydrates and fibres was significantly different in the two groups. Amino-acids were consumed less among the children at risk. Only 10% of children follow the recommendation for the proportion of calories supplied by fats. These results suggest that the intervention should be undertaken on dietary habits of the child as well as of its family in order to lower the risk of hypercholesterolemia.