Age, maturation and serum lipid parameters: findings from the German Health Survey for Children and Adolescents

Abstract

BackgroundRecommendations on preventive lipid screening among children and adolescents remain controversial. The aim of the study was to assess age and puberty-related changes in serum lipids, including total cholesterol (TC), and high-density (HDL-C) and non-high-density lipoprotein cholesterol (Non-HDL-C).MethodsUsing cross-sectional data from the National Health Interview and Examination Survey for Children and Adolescents in Germany (KiGGS 2003–2006; N = 13,676; 1–17 years), changes in distributions of serum lipids were visualized according to sex, age and maturation. Youth aged 10–17 years were classified as prepubescent, early/mid-puberty, and mature/advanced puberty. Multiple linear regressions were used to quantify the impact of pubertal stage on serum lipid levels, adjusted for potential confounding factors.ResultsAmong children 1–9 years mean serum lipid measures increased with age, with higher mean TC and Non-HDL-C among girls than boys. Among children 10–17 years, advanced pubertal stage was independently related to lower lipid measures. Adjusted mean TC, HDL-C and Non-HDL-C was 19.4, 5.9 and 13.6 mg/dL lower among mature/advanced puberty compared to prepubescent boys and 11.0, 4.0 and 7.0 mg/dL lower in mature/advanced puberty compared to prepubescent girls.ConclusionsLipid concentrations undergo considerable and sex-specific changes during physical growth and sexual maturation and significantly differ between pubertal stages. Screening recommendations need to consider the fluctuations of serum lipids during growth and sexual maturation.

Total cholesterol and low-density lipoprotein alterations in children and adolescents from Brazil: a prevalence meta-analysis

“…Higher rates of TC were detected in children when compared to adolescents, but no differences between boys and girls was observed. Lipoprotein concentrations changes considerably with normal growth and maturation, and varied according to sex (82)(83)(84)(85)(86). During pubertal growth, cholesterol is included in growing cells, leading to decreases in serum lipid values (87) but it increases on the later adolescence, approaching adult concentrations (84).…”

“…It is recommended that every child undergo a determination of TC level at 10 years of age by means of an examination of digital pulp capillary blood (4). Because adolescence is a critical period of life for the onset or persistence of obesity and its complications (86), knowing the nutritional status of this segment of the population is important.…”

Lipoprotein(a) in the Korean Pediatric Population Visiting Local Clinics and Hospitals

“…For example, the prevalence of precocious puberty, one reason for visiting local clinics and hospitals, is higher in girls than in boys [ 23 ]. Considering the possible association between hyperlipidemia and precocious puberty, this might result in differences between girls and boys who tested for serum lipoprotein(a) levels [ 24 ]; however, detailed clinical information was limited for this study.…”

Vorteile eines universellen frühkindlichen Screenings auf die familiäre Hypercholesterinämie in Deutschland

“…▶abb. 2 Verteilung der LDL-C Serumwerte nach Pubertätsstadien: Linie durchgezogen: präpubertär, kurz gestrichelt: pubertär, lang gestrichelt: postpubertär; nach [25].…”