Abstract
The objectives of this study were to determine the prevalence of dyslipidemia and the usefulness of self-report family history (FH) of premature cardiovascular disease (CVD) for identifying children with lipid disorders.
This study was conducted on a representative, population-based sample of 4811 Iranian children and adolescents (2248 boys and 2563 girls) aged 6–18 years. We compared the obtained serum lipid profile with that of the Lipid Research Clinic (LRC) and calculated the predictive value of FH for detecting those children with dyslipidemia.
Overall, for both genders and for age groups, the mean serum triglycerides (TG) and its percentiles were significantly higher, and the mean and percentiles of total, low-density, and high-density cholesterol (TC, LDL-C, and HDL-C respectively) were significantly lower than the LRC values. In total, 45.7% of participants had dyslipidemia; the most frequent ones were low HDL-C (24.8%) and hypertriglyceridemia (24.5%), followed by hypercholesterolemia (6.4%) and high LDL-C (6.3%), respectively. The mean serum lipid levels and the anthropometric measures were not significantly different among those with or without positive FH. The sensitivity, and specificity, positive and negative predictive values for FH in detecting those children with dyslipidemia were 28.4, 70.3. 44.7, and 53.8%, respectively.
The usefulness of FH in identifying dyslipidemic children was relatively low. The common lipid disorders in our community were the components of the metabolic syndrome. We suggest that the current guidelines for screening lipid disorders in youths, which are based on cholesterol, should consider such ethnic differences.
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References
American Academy of Pediatrics, Committee on Nutrition (1998) Cholesterol in childhood. Pediatrics 101:141–147
Azizi F, Mirmiran P, Azadbakht L (2004) Predictors of cardiovascular risk factors in Tehranian adolescents: Tehran Lipid and Glucose Study. Int J Vitam Nutr Res 74:307–312
Azizi F, Salehi P, Etemadi A, Zahedi-Asl S (2003) Prevalence of metabolic syndrome in an urban population: Tehran Lipid and Glucose Study. Diabetes Res Clin Pract 61:29–37
Bailleul S, Couderc R, Rossignol C, et al. (1995) Lipoprotein(a) in childhood: relation with other atherosclerosis risk factors and family history of atherosclerosis. Clin Chem 41:241–245
Berenson GS, Srinivasan SR, Bao W, et al. (1998) Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 338:1650–1656
Bergstrom E, Hernell O, Persson LA, Vessby B (1995) Serum lipid values in adolescents are related to family history, infant feeding, and physical growth. Atherosclerosis 117:1–13
Cohen MS (2004) Fetal and childhood onset of adult cardiovascular diseases. Pediatr Clin North Am 51:1697–1719
Davis CL, Flickinger B, Moore D, et al. (2005) Prevalence of cardiovascular risk factors in school children in a rural Georgia community. Am J Med Sci 330:53–59
De Backer G, De Henauw S, Sans S, et al. (1999) A comparison of lifestyle, genetic, bioclinical and biochemical variables of offspring with and without family histories of premature coronary heart disease: the experience of the European Atherosclerosis Research Studies. J Cardiovasc Risk 6:183–188
Fletcher RH, Fletcher SW (2005) Clinical Epidemiology: The Essential, 4th edn. Lippincott Williams & Wilkins Philadelphia, pp 35–55
Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18:499–502
Greenlund KJ, Valdez R, Bao WH, et al. (1997) Verification of parental history of coronary artery disease and associations with adult offspring risk factors in a community sample: The Bogalusa Heart Study. Am J Med Sci 313:220–227
Hippe M, Vestbo J, Bjerg AM, et al. (1997) Cardiovascular risk factor profile in subjects with familial predisposition to myocardial infarction in Denmark. J Emdemiol Community Health 51:266–271
Kavey RW, Daniels SR, Ronald M, et al. (2003) American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation 107:1562–1566
Kee F, Tiret L, Robo JY, et al. (1993) Reliability of reported family history of myocardial infarction. Br Med J 307:1528–1530
Kelishadi R, Hashemipour M, Sarraf-Zadegn N, Amiri M (2001) Trend of atherosclerosis risk factors in children of Isfahan. Asian Cardiovasc Thorac Ann 9:36–40
Kelishadi R, Pour MH, Sarraf-Zadegan N, et al. (2003) Obesity and associated modifiable risk factors in Iranian adolescents: IHHP-HHPC. Int Pediatr 45:435–442
Kelishadi R, Pour MH, ZadeganNS, et al. (2004) Fat intake and serum lipid profile in Iranian adolescents: IHHP-HHPC. Prev Med 39:760–766
Kelishadi R, Sarraf Zadegan N, Nadery GA, Asgary S, Bashardoust N (2002) Atherosclerosis risk factors in children and adolescents with or without family history of premature coronary artery disease. Med Sci Monit 8:425–429
Kelishadi R, Naderi Gh, Asgary S (2002) Oxidized LDL metabolites in children with high family risk for premature CVD. Ind J Pediatr 69:755–759
Kelishadi R, Sabet B, Khosravi A (2003) Anticardiolipin antibody of adolescents and age of myocardiial infraction in parents. Med Sci Monit 9:515–518
Kelishadi R, Derakhshan R, Sabet B, et al. (2005) The metabolic syndrome in hypertensive and normotensive subjects: the Isfahan Healthy Heart Programme. Ann Acad Med Singapore 34:243–249
Kolahdooz F, Sheikholeslam R, Naghavi M, et al. (2004) Junk food consumption: an indicator of changing dietary habit in Iranian children. Asia Pac J Clin Nutr 13(Suppl):S121
Makedou A, Kourti M, Makedou K, Lazaridou S, Varlamis G (2005) Lipid profile of children with a family history of coronary heart disease or hyperlipidemia: 9-yearexperience of an outpatient clinic for the prevention of cardiovascular diseases. Angiology 56:391–395
Martin LM, Leff M, Calonge N, Garrett C, Nelson DE (2000) Validation of self-reported chronic conditions and health services in a managed care population. Am J Prev Med l8:215–218
McNamara JR, Schaefer EJ (1987) Automated enzymatic standardized lipid analyses for plasma and lipid lipoprotein fractions. Clin.Chem Acta 166:1–8
Muratova VN, Islam SS, Demerath EW, Minor VE, Neal WA (2001) Cholesterol screening among children and their parents. Prev Med 33:1–6
National Cholesterol Education Program (NECP) expert panel (ATPIII) (2001) Executive summary of the third report of the National Cholesterol Education Program (NECP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). J Am Med Assoc 285:2486–2497
Okada T, Sato Y, Yamazaki K, et al. (1995) Lipoprotein(a) and apolipoprotein A-1 and B in schoolchildren whose grandparents had coronary vascular events: a preliminary study of 12–13 year old Japanese children. Acta Paediatr Jpn 37:582–587
O’Loughlin J, Lauzon B, Paradis G, et al. (2004) Usefulness of the American Academy of Pediatrics Recommendations for Identifying Youths with Hypercholesterolemia. Pediatrics 13: 1723–1727
Pankow JS, Folsom AR, Province MA, et al. (1997) Family history of coronary heart disease and hemostatic variables in middle-aged adults. Thromb Haemost 77:87–9332
Personen E, Liuba P (2004) Footprints of atherosclerotic coronary heart disease in children. Rev Port Cardiol 23:127–131
Prieto Albino L, Arroyo Diez J, Vadillo Machota JM, Mateos Montero C, Galan Rebollo (1998) Prevalence of hyperlipidemia in children and adolescents in the Province of Caceres, Rev Esp Salud Publica 72:343–355
Tershakovec AM, Rader J (2004) Disorders of lipoprotein metabolism and transport. In: Behnnan RE, Kliegman RM, Jenson HB (eds) Nelson Textbook of Pediatrics 17th edn Saunders, Philadelphia, pp 445–459
Warnick GR, Benderson J, Albers JJ (1982) Dextran sulfate-magnesium precipitation procedure for quantitation of high-density lipoprotein cholesterol. Clin Chem 28:1379–1382
Yusuf S, Reddy S, Anand O, et al. (2001) Global burden of cardiovascular diseases? Part II. Variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 104:2855–2864
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This project was funded by grant TSA03/11 WHO/EMR and the Iranian Ministries for Health and for Education. We thank team members who are working on this project.
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Kelishadi, R., Ardalan, G., Gheiratmand, R. et al. Is Family History of Premature Cardiovascular Diseases Appropriate for Detection of Dyslipidemic Children in Population-Based Preventive Medicine Programs? CASPIAN Study. Pediatr Cardiol 27, 729–736 (2006). https://doi.org/10.1007/s00246-006-1391-3
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DOI: https://doi.org/10.1007/s00246-006-1391-3