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Summarvof atherosclerotic cardiovascular disease (5. 17). The epidemiolog-The age-, race-, and sex-specific distributions for plasma cholesterol (CH) and triglyceride (TG) are described for the 13,655 individuals under 20 years of age who were examined at the first visit (visit I) of the Prevalence Study of the Lipid Research Clinics (LRC) Program. Composite findings are presented from the seven North American LRC's where children were included in the target population. Cholesterol values are higher for blacks than for whites, but triglyceride values are higher for whites than for blacks. In both the C H and TG distributions for the combined races, the mean values for females are generally higher than for males. For cholesterol, consistent age-associated differences occur. On average. the CH values peak in late childhood and decline during adolescence. The decrease in mean values for C H is most marked for white males. The values for T C tend to increase in early adolescence. This report expands the available information about lipid distributions in young populations and describes the extent of the variation in plasma lipids associated with race and sex for each year of age, 0 to 19 years. SpeculationThe pattern of age-associated differences found in these population-based, cross-sectional surveys points to the need for prospective studies of lipid levels in cohorts examined before puberty and followed throughout adolescence and into early childhood. Such longitudinal studies may reveal the biological explanation for the age-curve of the mean values for lipids.

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over 4 y e a r s could be accounted f o r by t h e phenomenon of r e g r e s s i o n toward t h e mean, with t h e exception of C-LDLwherethe observed means d i d not i n c r e a s e a s one would expect due t o r e g r e s s i o n towards t h e mean ( 2.05). a f u r t h e r example of t i g h t t r a c k i n g a t law C-LDL l e v e l s . For c h i l d r e n whose i n i t i a l t o t a l plasma, c h o l e s t e r o l , t r i g l y c e r i d e , C-LDL. and C-HDL were i n t h e h i g h e s t d e c i l e , 46% ( f o r c h o l e s t e r o l ) , 27% ( f o r t r i g l yc e r i d e ) . 27% ( f o r C-LDL), and 45% ( f o r C-HDL) remained i n the h i g h e s t d e c i l e a f t e r 4 y e a r s follow-up.For a l l 108 c h i l d r e n , i n i t i a l plasma c h o l e s t e r o l . t r i g l y c e r i d e . C-LDL, and C-HDL were a l l c l o s e l y c o r r e l a t e d w i t h subsequent measurements 1. 2, and 3 y e a r s a p a r t , p 5. Such f i n d i n g s r a i s e t h e possib i l i t y t h a t c h i l d r e n who tend t o t r a c k i n t h e lowest and h i g h e s t d e c i l e s f o r c h o l e s t e r o l nnd C-LDLmay mature t o become a d u l t s r e s p e c t i v e l y a t reduced and increased coronary h e a r t d i s e a s e (CHD) r i s k . Children who tend t o t r a c k i n t h e lowest and h i g h e s t d e c i l e s f o r C-HDL may a l s o mature t o become a d u l t s r e s p e c t i v e l y a t increased and reduced CHD r i s k . Although t h e degree of tracki n g a t e i t h e r extreme of t h e d i s t r i b u t i o n and f o r t h e group as a whole appears t o have cohesiveness and may be u s e f u l f o r p r e d i c t i o n of f u t u r e l i p i d and l i p o p r o t e i n l e v e l s , i n d i v i d u a l c h i l d r e n a t t h e extremes of t h e d i s t r i b u t i o n s w i l l need t o be followed over longer p e r i o d s of time, t o i d e n t i f y t h e c o n t i n u i t y of childhood and a d u l t v a SPECULATIONChildren who tend t o t r a c k i n t h e lowest and h i g h e s t d e c i l e s f o r cholest e r o l and C-LDL may mature t o become a d u l t s r e s p e c t i v e l y a t reduced and increased coronary h e a r t d i s e a s e (CHD) r i s k . Children who tend t o t r a c k i n t h e l o v e s t and h i g h e s t d e c i l e s f o r C-HDL may a l s o mature t o become a d u l t s r e s p e c t i v e l y a t increased and reduced CHD r i s k .