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Lipid profile assessed in the family pediatrician's office: the COLIBRI'- SIMPeF study
Marco Giussani1, Laura Antolini2, Monica De' Angelis1
1Family Pediatrician, ATS Milan, SIMPeF, Milan, Italy.
Insights
Dyslipidemia is common in Italian children, with family history increasing high cholesterol risk. Pediatricians can screen for these lipid issues in their offices, identifying risks early.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Metabolic Syndrome
Background:
- Limited data exists on dyslipidemia prevalence in Italian children.
- Early intervention for hypercholesterolemia can prevent future cardiovascular events.
- Screening guidelines for childhood dyslipidemia lack universal agreement.
Purpose of the Study:
- To assess lipid profiles (total cholesterol, HDL-cholesterol, triglycerides) in a large Italian pediatric cohort.
- To identify factors associated with dyslipidemia in children aged 7-11 years.
- To evaluate the feasibility of micro-sampling for lipid assessment in pediatric primary care settings.
Main Methods:
- A micro-sampling procedure was used in family pediatrician offices.
- 1910 Italian children (ages 7-11) participated.
- Data collected included lipid levels, BMI z-scores, and family history of hypercholesterolemia.
Main Results:
- Dyslipidemia prevalence: 4.5% elevated total cholesterol, 23.5% elevated triglycerides, 3.3% low HDL cholesterol.
- Male gender and positive family history were independent predictors of hypercholesterolemia.
- Increased BMI z-score correlated with low HDL cholesterol and high triglycerides.
Conclusions:
- Dyslipidemia prevalence in Italian children warrants attention.
- Family history is a significant risk factor for hypercholesterolemia, independent of weight.
- Pediatrician office-based lipid screening is feasible and valuable for early diagnosis, particularly for familial hypercholesterolemia.
Abstract:
There is limited information on the prevalence of dyslipidemia in the Italian pediatric population. Aim of the study was to evaluate total cholesterol, high-density lipoprotein (HDL)-cholesterol and triglyceride levels, and associated factors in a large sample of Italian children, applying a micro-sampling procedure in the family pediatrician's office. In a population of 1910 children (50.2% males, age 7-11 years), 27.6% was overweight or obese and 28.3% had at least one parent with referred hypercholesterolemia. Total cholesterol and triglyceride levels were elevated in 4.5% and 23.5% of the subjects, respectively, while HDL cholesterol was below 40 mg/dl in 3.3%. Male gender (OR 1.58, 95% CI 1.01-2.49) and positive family history (OR 2.13, 95% CI 1.36-3.32) were independent predictors of hypercholesterolemia, while BMI z-score was associated with low HDL cholesterol (OR 1.46, 95% CI 1.13-1.88) and high levels of triglycerides (OR 1.39, 95% CI 1.26-1.55).Conclusion: The prevalence of dyslipidemia in our sample is worthy of attention. The study suggests the opportunity and feasibility to check for the presence of dyslipidemia at the family pediatrician's office. Familiarity is associated with high cholesterol levels, regardless of the children's weight class, while weight excess identifies subjects with the typical lipid profile of metabolic syndrome. What is Known: • Few data are available on the lipid profile in Italian children. • Early treatment of hypercholesterolemia is effective in reducing cardiovascular events later in life; there is no agreement on how to screen for dyslipidemia in childhood, however. What is New: • In a large sample of Italian children, familiarity doubles the risk of hypercholesterolemia, while increased BMI is associated with low HDL cholesterol levels and hypertriglyceridemia. • The pediatrician may perform an assessment of plasma lipids in his office as a first step to diagnose familial hypercholesterolemia.
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