Utility of Childhood Non–High-Density Lipoprotein Cholesterol Levels in Predicting Adult Dyslipidemia and Other Cardiovascular Risks: The Bogalusa Heart Study

Srinivasan, Sathanur R.; Frontini, María; Xu, Jihua; Berenson, Gerald S.

doi:10.1542/peds.2005-1856

Cited by 169 publications

(131 citation statements)

References 39 publications

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“…In addition, even low-density lipoprotein (LDL) cholesterol, which was recently related to cardiovascular risk-factors and showed longterm tracking power, should be included as parameter to measure. 42,111,112 When new research fills these knowledge gaps, insulin and lipid-profile parameters, which we believe are both potential factors to consider, could be included as components for evaluation. Returning to evidence-based items and looking at clinical management of such a list (Table 4), we can determine the presence or the absence of each factor in the individual.…”

Section: Potential Factorsmentioning

confidence: 99%

Metabolic risk-factor clustering estimation in children: to draw a line across pediatric metabolic syndrome

et al. 2007

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Background: The diagnostic criteria of the metabolic syndrome (MS) have been applied in studies of obese adults to estimate the metabolic risk-associated with obesity, even though no general consensus exists concerning its definition and clinical value. We reviewed the current literature on the MS, focusing on those studies that used the MS diagnostic criteria to analyze children, and we observed extreme heterogeneity for the sets of variables and cutoff values chosen. Objectives: To discuss concerns regarding the use of the existing definition of the MS (as defined in adults) in children and adolescents, analyzing the scientific evidence needed to detect a clustering of cardiovascular risk-factors. Finally, we propose a new methodological approach for estimating metabolic risk-factor clustering in children and adolescents. Results: Major concerns were the lack of information on the background derived from a child's family and personal history; the lack of consensus on insulin levels, lipid parameters, markers of inflammation or steato-hepatitis; the lack of an additive relevant effect of the MS definition to obesity per se. We propose the adoption of 10 evidence-based items from which to quantify metabolic risk-factor clustering, collected in a multilevel Metabolic Individual Risk-factor And CLustering Estimation (MIRACLE) approach, and thus avoiding the use of the current MS term in children. Conclusion: Pediatricians should consider a novel and specific approach to assessing children/adolescents and should not simply derive or adapt definitions from adults. Evaluation of insulin and lipid levels should be included only when specific references for the relation of age, gender, pubertal status and ethnic origin to health risk become available. This new approach could be useful for improving the overall quality of patient evaluation and for optimizing the use of the limited resources available facing to the obesity epidemic.

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Section: Potential Factorsmentioning

confidence: 99%

Metabolic risk-factor clustering estimation in children: to draw a line across pediatric metabolic syndrome

et al. 2007

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“…However, during the 27 years of follow-up of the Bogalusa Heart Study, 66.2% of the dyslipidemic subjects in the two highest quintiles for non-HDL cholesterol levels remained in the same quintiles during adulthood (24).…”

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confidence: 95%

Early coronary calcifications are related to cholesterol burden in heterozygous familial hypercholesterolemia

Gallo

Giral

Carrié

et al. 2017

Journal of Clinical Lipidology

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“…16,17 Finally, in reports of studies of both adults and children, various authors have questioned the added value of cardiovascular risk assessment of LDL cholesterol levels beyond TC, HDL, and non-HDL cholesterol levels. [18][19][20][21][22] Because of the added burden of fasting before screening and the emerging research data that call into question the value of fasting before lipid assessment of cardiovascular risk in adults, we sought to determine the effect of fasting on complete lipid panels in children. Specifically, we took advantage of variable fasting times within the nationally representative National Health and Nutrition Survey (NHANES) to determine if there are differences in TC, HDL, LDL, and non-HDL cholesterol between blood samples from fasting and nonfasting study participants.…”

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confidence: 99%

Fasting Might Not Be Necessary Before Lipid Screening: A Nationally Representative Cross-sectional Study

2011

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WHAT'S KNOWN ON THIS SUBJECT:Fasting lipid panels are recommended to screen for lipid abnormalities; however, fasting can be difficult for children and make screening difficult. Results of studies in adult patients are raising questions of whether fasting is needed before lipid screening. WHAT THIS STUDY ADDS:In a nationally representative sample of children, small but likely unimportant differences in lipid panel results were found between children who had fasted and those who had not fasted before testing, which indicates that fasting before lipid screening in children might not be necessary. abstract BACKGROUND: There are barriers to fasting lipid screening for at-risk children. Results of studies in adults have suggested that lipid testing might be reliably performed without fasting. OBJECTIVE:To examine population-level differences in pediatric lipid values based on length of fast before testing. METHODS:We used the National Health and Nutrition Examination Survey (1999Survey ( -2008 to examine total cholesterol (TC), HDL (high-density lipoprotein), LDL (low-density lipoprotein), and triglyceride cholesterol components on the basis of the period of fasting. Young children fasted for varying times before being tested, and children older than 12 years were asked to fast; however, adherence was variable. We used ordinary least-squares regression to test for differences in lipid values that were based on fasting times, controlling for weight status, age, race, ethnicity, and gender.RESULTS: TC, HDL, LDL, or triglyceride values were available for 12 744 children. Forty-eight percent of the TC and HDL samples and 80% of the LDL and triglyceride samples were collected from children who had fasted Ն8 hours. Fasting had a small positive effect for TC, HDL, and LDL, resulting in a mean value for the sample that was 2 to 5 mg/dL higher with a 12-hour fast compared with a no-fast sample. Fasting time had a negative effect on triglycerides (␤ ϭ Ϫ0.859; P ϭ .02), which resulted in values in the fasting group that were 7 mg/dL lower. DISCUSSION:Comparison of cholesterol screening results for a nonfasting group of children compared with results for a similar fasting group resulted in small differences that are likely not clinically important. Physicians might be able to decrease the burden of childhood cholesterol screening by not requiring prescreening fasting for these components.

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Utility of Childhood Non–High-Density Lipoprotein Cholesterol Levels in Predicting Adult Dyslipidemia and Other Cardiovascular Risks: The Bogalusa Heart Study

Abstract: Adverse levels of non-high-density lipoprotein cholesterol versus low-density lipoprotein cholesterol in childhood not only equally persist over time and better predict adult dyslipidemia but also are related to nonlipid cardiovascular risk factors in adulthood.

Cited by 169 publications

References 39 publications

Metabolic risk-factor clustering estimation in children: to draw a line across pediatric metabolic syndrome

Metabolic risk-factor clustering estimation in children: to draw a line across pediatric metabolic syndrome

Early coronary calcifications are related to cholesterol burden in heterozygous familial hypercholesterolemia

Fasting Might Not Be Necessary Before Lipid Screening: A Nationally Representative Cross-sectional Study

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