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Serum lipid and lipoprotein cholesterol grids for cardiovascular risk screening of children
Insights
This study establishes serum lipid and lipoprotein percentiles for children aged 2-19, offering a screening method for hyperlipoproteinemia. These findings aid in identifying children needing lipid disorder evaluation and family screening.
Area of Science:
- Pediatrics
- Clinical Chemistry
- Public Health
Background:
- Serum lipid and lipoprotein levels are critical indicators of cardiovascular health in children.
- Establishing population-specific percentiles is essential for accurate interpretation of pediatric lipid profiles.
- Existing screening methods may not adequately address diverse pediatric populations.
Purpose of the Study:
- To determine serum lipid and lipoprotein percentiles in a large, diverse pediatric community cohort.
- To validate a rapid, inexpensive screening test (serum turbidity index) for hyperlipoproteinemia in children.
- To provide race- and sex-specific percentile grids for key lipid and lipoprotein parameters.
Main Methods:
- Community-based study of 5,250 fasting children (2-19 years; 35% black, 65% white).
- Measurement of serum lipid and lipoprotein levels, including total cholesterol, beta-lipoprotein cholesterol, triglyceride, pre-beta-lipoprotein cholesterol, and alpha-lipoprotein cholesterol.
- Utilized a serum turbidity index as a screening tool for hyper-beta-lipoproteinemia and hyper-pre-beta-lipoproteinemia.
Main Results:
- Established percentile grids for serum turbidity index, total cholesterol, and beta-lipoprotein cholesterol applicable to both black and white children.
- Developed race-specific percentile grids for triglyceride and pre-beta-lipoprotein cholesterol due to observed differences in black children.
- Provided sex-specific percentile grids for alpha-lipoprotein cholesterol by race.
Conclusions:
- The serum turbidity index is a viable, cost-effective screening tool for pediatric hyperlipoproteinemia.
- Race- and sex-specific percentile data are crucial for accurate lipid and lipoprotein assessment in children.
- The outlined five-step screening method facilitates early detection and management of pediatric lipid abnormalities, prompting family screening.
Abstract:
We determined serum lipid and lipoprotein percentiles from a total community study of 5,250 fasting children (35% black, 65% white), aged 2 to 19 years. A serum turbidity index was used as a rapid, inexpensive screening test for hyper-beta-lipoproteinemia and hyper-pre-beta-lipoproteinemia. Percentile grids for the turbidity index and serum total cholesterol and beta-lipoprotein cholesterol levels may be used for either black or white children. Triglyceride and pre-beta-lipoprotein cholesterol level percentile grids were reported by race because of lower levels in black children, while grids for alpha-lipoprotein cholesterol levels were reported separately by sex for black and white subjects. A five-step method was outlined for screening children for lipid and lipoprotein abnormalities. Those with hyper-beta-lipoproteinemia and hyperpre-beta-lipoproteinemia would be candidates for therapy and indicate screening of other family members, after secondary causes are excluded.