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Lipid temporal trends in normal-weight youth
Justin P Zachariah1, Teniola Shittu1, Yunfei Wang1
1Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX.
American Heart Journal
|October 23, 2020
Summary
Despite worsening childhood obesity, abnormal lipids improved. A significant portion of youth with high cholesterol were normal weight, indicating a need to re-evaluate screening and management strategies.
Area of Science:
- Cardiology
- Pediatrics
- Public Health
Background:
- Atherosclerosis risk begins in youth, influenced by excess weight (EW) and abnormal lipid profiles.
- Pediatric obesity rates have risen, yet lipid profiles in youth have paradoxically improved.
- Understanding lipid trends in normal-weight (NW) youth is crucial given the association between EW and dyslipidemia.
Purpose of the Study:
- To examine the proportions and temporal trends of normal-weight (NW) versus excess-weight (EW) youth with abnormal lipid levels.
- To investigate how weight status modifies the temporal trends of dyslipidemia in adolescents.
- To inform strategies for universal lipid screening and weight management in pediatric populations.
Main Methods:
- Analysis of National Health and Nutrition Examination Surveys (NHANES) data from 1988-2016.
- Inclusion of 10- to 20-year-olds (N=14,785) with anthropometric and laboratory data for lipid assessment.
- Survey-weighted regression analysis incorporating a weight-status interaction term to assess effect modification on lipid trends.
Main Results:
- Prevalence of EW increased, while dyslipidemia prevalence decreased over time (P < .001 for both).
- EW more than doubled the risk for each type of lipid disorder (P < .0001).
- 26%-63% of youth with abnormal lipids were NW; the proportion of NW youth with abnormal lipids declined as overall dyslipidemia decreased, with differing temporal trends for HDL-C.
Conclusions:
- Normal-weight youth constitute a substantial proportion (26%-63%) of adolescents with abnormal lipids.
- Temporal trends indicate a declining proportion of NW youth among those with dyslipidemia.
- Findings challenge conventional wisdom, highlighting the importance of considering NW individuals in lipid screening and management discussions.
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