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[HDL cholesterol in children. Its influence on the diagnosis of hypercholesterolemia]
M Sánchez Bayle1, M L Fernández Ruiz
1Grupo de Trabajo sobre Factores de Riesgo Cardiovascular en la Infancia y la Adolescencia, Hospital del Niño Jesús, Madrid.
Insights
High-density lipoprotein cholesterol (HDL-C) levels are frequently elevated in children and adolescents, potentially contributing to high total cholesterol (TC) values. Further investigation is needed to understand the implications of these lipid profiles in pediatric populations.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Lipid Metabolism
Background:
- Elevated total cholesterol (TC) in childhood is a growing concern for long-term cardiovascular health.
- Understanding the role of high-density lipoprotein cholesterol (HDL-C) in pediatric lipid profiles is crucial for early risk assessment.
Purpose of the Study:
- To evaluate high-density lipoprotein cholesterol (HDL-C) levels in children and adolescents.
- To determine the relationship between HDL-C and high total cholesterol (TC) values in this demographic.
Main Methods:
- Analysis of lipid profiles from 4,547 children and adolescents aged 4-6 years.
- Assessment of high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) concentrations.
- Calculation of positive predictive values (PPV) for detecting elevated low-density lipoprotein cholesterol (LDL-C) and LDL-C/HDL-C ratios.
Main Results:
- A significant percentage of children exhibited high HDL-C levels (e.g., >50 mg/dl in 66.28%).
- 44.8% of participants had TC > 174.9 mg/dl, and 15.17% had TC > 199.9 mg/dl.
- The PPV for detecting elevated LDL-C or LDL-C/HDL-C ratios based on TC levels varied, indicating complex lipid dynamics.
Conclusions:
- Elevated HDL-C in children and adolescents may contribute to observed high TC levels.
- Children with TC between 174.9 and 199.9 mg/dl typically do not present with increased LDL-C or LDL-C/HDL-C ratios.
- These findings highlight the importance of considering HDL-C in the context of pediatric cholesterol screening.
Objective:
The purpose of this study was to evaluate HDL-C values and their relationship to high total cholesterol values during childhood.
Patients And Methods:
We have studied 4,547 children and adolescents of both sexes between 4 and 6 years of age.
Results:
We found HDL-C values > 50, 65 and 75 mg/dl in 66.28%, 26.17% and 7.81%, respectively. Of the cases studied, 44.8% had TC > 174.9 mg/dl and 15.17% higher than 199.9 mg/dl. The positive predictive value (PPV) to detect LDL-C > 129.9 mg/dl was 67.1 and 26.4 for values of TC > 199.9 and 174.9, respectively. The PPV to detect a LDL-C/HDL-C > 2.19 of the TC > 199.9 and 174.9 mg/dl was 54.78 and 23.95, respectively.
Conclusions:
The HDL-C of children and adolescents is often high and this could be responsible for the high TC values. Most of the children with TC values between 174.9 and 199.9 mg/dl have neither an increase in LDL-C nor in the LDL-C/HDL-C ratio.