Cardiometabolic risk factors in siblings from a statewide screening program

Area of Science:

• Pediatric Cardiology
• Public Health
• Genetics

Background:

• The Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project screened over 100,000 5th graders for obesity, hypertension, and dyslipidemia.
• This study focused on siblings within the CARDIAC Project to explore familial correlations in cardiometabolic risk factors (CMRFs).

Purpose of the Study:

• To investigate the correlation of cardiometabolic risk factors (CMRFs) among siblings.
• To determine if sibling CMRFs can predict individual risk and inform screening strategies.

Main Methods:

• Utilized data from 12,053 children across 5752 families, including lipid panels, blood pressure, and anthropometric measurements.
• Employed linkage software (LinkPlus) to match siblings and conducted graphical and statistical analyses to assess CMRF relationships.

Main Results:

• Moderate intraclass correlations were found for LDL-C (0.375), HDL-C (0.34), and BMI (0.383) among siblings.
• Sibling LDL-C showed a stronger correlation than an individual's BMI, with significant odds ratios for elevated LDL-C (≥160 mg/dL) in siblings (29.6:1).
• Family history was a poor predictor of cholesterol abnormalities, potentially missing over half of children with elevated LDL-C.

Conclusions:

• Sibling LDL-C, HDL-C, and BMI levels are correlated within families, though triglycerides and blood pressure show weaker correlations.
• Elevated LDL-C in a child strongly suggests screening siblings and parents, as family history is insufficient for identifying at-risk individuals.
• Findings reinforce that elevated BMI does not predict elevated LDL-C and family history inadequately identifies children needing cholesterol screening.