The differences of lipid profiles between only children and children with siblings: A national survey in China

Abstract

With the increasing number of the one-child family, it is important to investigate whether the only-child status is associated with dyslipidemia. Among a national sample of 65,347 Chinese children aged 6–17 years, 16,100 lipid profiles were available. Children’s height, weight, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured. In comparison to children with siblings, only children (OC) were more likely to be boys and live in urban areas. OC had less physical activity, less fried food intake, but more meat and dairy intakes. OC had significantly higher levels of TC (3.97 ± 0.78 vs. 3.89 ± 0.77) and LDL-C (2.12 ± 0.65 vs. 2.06 ± 0.64) in the overall group, and also in the subgroups of rural boys and girls. The prevalence of hyper-TC (5.48% vs. 4.43%) and hyper-LDL-C (3.97% vs. 2.96%) were significantly higher in OC than their counterparts. Furthermore, we found higher odds of hyper-LDL-C [1.43 (1.12, 1.83)] in OC after adjustments. In the subgroup analysis, only-child status was associated with increased risk of hyper-TC [1.86 (1.06, 3.26)] and hyper-LDL-C [2.65 (1.14, 6.16)] among rural boys, and hyper-LDL-C among rural girls [2.20 (1.14, 4.22)]. In conclusion, higher levels of TC and LDL-C were found in OC especially for rural children. Being an only-child was associated with increased risk of hyper-LDL-C.

The independent and combined effects of single-child status and ideal lifestyle on clustered cardio-metabolic risk factors among Chinese children and adolescents

“…The associations between the single children and an increased risk of elevated blood pressure (35), dyslipidemia (10), hypertension (13), abdominal obesity (11,35), overweight and obesity (36, 37) were confirmed in China and European countries. However, one study found the opposite results that children with siblings were associated with a higher risk of hypertension (12), which the authors believed was likely attributed to adjustments for BMI or obesity status.…”

“…Based on this, many studies have noted the impact of different family structures on CMRFs, as well as sex differences. Recent studies provided evidence for the association of single children with components of CMRFs such as dyslipidemia ( 10 ), abdominal obesity ( 11 ), and hypertension ( 12 ) in children and adolescents, however, the findings were inconsistent in the direction of the association and sex differences. In addition, only one Iranian study explored the association between single children and all components of CMRFs, and this positive association was mainly manifested in abdominal obesity ( 13 ).…”

Sex Differences in the Association of Sibship Size and Position in Sibship with Lipid Profile during Adolescence: A Cross-Sectional Study

“…Few prior studies have investigated the associations between sibship characteristics and lipid profile and reported mixed results [17][18][19][20]. Two studies have shown that lipid profile was not significantly different when comparing firstborns to laterborns [17,18].…”

“…Previous studies have investigated the sibling effect on lipid profile using dichotomous approaches (e.g., firstborns versus laterborns or only-children versus children with siblings) [17][18][19][20], which did not allow to investigate a doseresponse relationship between lipid profile and sibship size or position of the child in the sibship. Such an approach will help to better uncover the true relationship between sibling effect and lipid profile and to understand the potential mode of action of siblings.…”

“…In contrast, an unfavorable lipid profile in firstborns compared to laterborns was reported among male Brazilian adolescents aged 17 to 19 years [ 19 ]. A study based on a large sample of Chinese children aged 6 to 17 years has shown that only-children had an abnormal lipid profile compared to children with siblings [ 20 ]. These results suggest a possible influence of siblings on the lipid profile, which is important, since lipid abnormalities in childhood/adolescence track into adulthood and are indicators of future cardiovascular diseases [ 21 – 23 ].…”