Data from a study of more than 16,000 U.S. children and adolescents showed a decrease in average total cholesterol over the past two decades, although almost one in 10 had elevated total cholesterol in 2007-10.
Brian K. Kit, MD, MPH, of the U.S. Centers for Disease Control and Prevention, and colleagues conducted a study to examine the trends in serum lipid concentrations among children and adolescents in the U.S. The study included data on 16,116 youths ages 6 to 19 who participated in the nationally representative National Health and Nutrition Examination Survey during 1988-1994,1999-2002 and 2007-2010.
Trends in adverse lipid concentrations were reported for total cholesterol levels of 200 milligrams per deciliter and greater, non-HDL-C levels of 145 mg/dL and greater, HDL-C levels of less than 40 mg/dL, LDL-C levels of 130 mg/dL and greater, and triglyceride levels of 130 mg/dL and greater.
Reporting in the Aug. 8 issue of the Journal of the American Medical Association, the researchers found that among youths ages 6 to 19 between 1988-1994 and 2007-2010, there was a decrease in average serum total cholesterol from 165 mg/dL to 160 mg/dL and an increase in average serum HDL-C from 50.5 mg/dL to 52.2 mg/dL. They also found a decrease in average serum non-HDL-C levels during this time period.
"Generally, the sex-, age- and race/ethnicity-specific trends for TC [total cholesterol], HDL-C and non-HDL-C were similar in direction to the overall trends and consistent with a favorable trend, although for each group, the magnitude was not the same and the trend was not always significant," the authors wrote.
Between 1988-1994 and 2007-2010, there was a decrease from 11.3% to 8.1% in prevalence of elevated total cholesterol among youths ages 6 to 19, and a decrease from 13.6% to 10% in prevalence of elevated non-HDL-C.
The prevalence of low HDL-C was 17.3% in 1988-1994 and 14.8% in 2007-2010, a non-significant decrease. Among adolescents, the researchers found a decrease in prevalence of elevated LDL-C and triglycerides between 1988-1994 and 2007-2010, and a decrease in average serum LDL-C from 95 mg/dL to 90 mg/dL and geometric average serum triglycerides from 82 mg/dL to 73 mg/dL.
In 2007-2010, 22% of youths had either a low HDL-C level or high non-HDL-C, which was lower than the 27.2% rate in 1988-1994.
The authors also found that age- and race/ethnicity-adjusted total cholesterol was 4.3 mg/dL lower for males and 6.5 mg/dL lower for females in 2007-2010 than in 1988-1994. Males and females who were non-Hispanic black or Mexican American and females who were non-Hispanic white had a lower age-adjusted total cholesterol in 2007-2010 than in 1988-1994. Age- and race/ethnicity- adjusted HDL-C was higher for males and females in 2007-2010 than in 1988-1994.
While noting the "favorable trend" in serum lipid concentrations, the authors wrote that "adverse lipid profiles continue to be observed among youths."
For example, they wrote, in 2007-10, slightly more than 20% of children ages 9 to 11 had either a low HDL-C or high non-HDL-C concentration, "which, according to the most recent cardiovascular health guidelines for children and adolescents, indicates a need for additional clinical evaluation."
The authors noted that the recently released "Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents" (http://1.usa.gov/s2ag4H) "provides recommendations for preventing the development of cardiovascular risk factors including optimizing nutrition and physical activity and reducing exposure to tobacco smoke. Specific screening approaches, including universal screening at select ages and management of adverse lipid concentrations, have also been detailed in these recent guidelines for youths.
"Future research from longitudinal studies or mortality-linked data, including NHANES, may include examining clinical outcomes for cardiovascular disease, including cardiovascular mortality, based on lipid concentrations present during childhood."
To read the study abstract and access the study via subscription or purchase, visit http://bit.ly/N0Nw80.
Brian K. Kit, MD, MPH, of the U.S. Centers for Disease Control and Prevention, and colleagues conducted a study to examine the trends in serum lipid concentrations among children and adolescents in the U.S. The study included data on 16,116 youths ages 6 to 19 who participated in the nationally representative National Health and Nutrition Examination Survey during 1988-1994,1999-2002 and 2007-2010.
Trends in adverse lipid concentrations were reported for total cholesterol levels of 200 milligrams per deciliter and greater, non-HDL-C levels of 145 mg/dL and greater, HDL-C levels of less than 40 mg/dL, LDL-C levels of 130 mg/dL and greater, and triglyceride levels of 130 mg/dL and greater.
Reporting in the Aug. 8 issue of the Journal of the American Medical Association, the researchers found that among youths ages 6 to 19 between 1988-1994 and 2007-2010, there was a decrease in average serum total cholesterol from 165 mg/dL to 160 mg/dL and an increase in average serum HDL-C from 50.5 mg/dL to 52.2 mg/dL. They also found a decrease in average serum non-HDL-C levels during this time period.
"Generally, the sex-, age- and race/ethnicity-specific trends for TC [total cholesterol], HDL-C and non-HDL-C were similar in direction to the overall trends and consistent with a favorable trend, although for each group, the magnitude was not the same and the trend was not always significant," the authors wrote.
Between 1988-1994 and 2007-2010, there was a decrease from 11.3% to 8.1% in prevalence of elevated total cholesterol among youths ages 6 to 19, and a decrease from 13.6% to 10% in prevalence of elevated non-HDL-C.
The prevalence of low HDL-C was 17.3% in 1988-1994 and 14.8% in 2007-2010, a non-significant decrease. Among adolescents, the researchers found a decrease in prevalence of elevated LDL-C and triglycerides between 1988-1994 and 2007-2010, and a decrease in average serum LDL-C from 95 mg/dL to 90 mg/dL and geometric average serum triglycerides from 82 mg/dL to 73 mg/dL.
In 2007-2010, 22% of youths had either a low HDL-C level or high non-HDL-C, which was lower than the 27.2% rate in 1988-1994.
The authors also found that age- and race/ethnicity-adjusted total cholesterol was 4.3 mg/dL lower for males and 6.5 mg/dL lower for females in 2007-2010 than in 1988-1994. Males and females who were non-Hispanic black or Mexican American and females who were non-Hispanic white had a lower age-adjusted total cholesterol in 2007-2010 than in 1988-1994. Age- and race/ethnicity- adjusted HDL-C was higher for males and females in 2007-2010 than in 1988-1994.
While noting the "favorable trend" in serum lipid concentrations, the authors wrote that "adverse lipid profiles continue to be observed among youths."
For example, they wrote, in 2007-10, slightly more than 20% of children ages 9 to 11 had either a low HDL-C or high non-HDL-C concentration, "which, according to the most recent cardiovascular health guidelines for children and adolescents, indicates a need for additional clinical evaluation."
The authors noted that the recently released "Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents" (http://1.usa.gov/s2ag4H) "provides recommendations for preventing the development of cardiovascular risk factors including optimizing nutrition and physical activity and reducing exposure to tobacco smoke. Specific screening approaches, including universal screening at select ages and management of adverse lipid concentrations, have also been detailed in these recent guidelines for youths.
"Future research from longitudinal studies or mortality-linked data, including NHANES, may include examining clinical outcomes for cardiovascular disease, including cardiovascular mortality, based on lipid concentrations present during childhood."
To read the study abstract and access the study via subscription or purchase, visit http://bit.ly/N0Nw80.
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