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Cholesterol screening in childhood: Results of a 9-year follow-up study in Swiss and Italian children in Switzerland

deCholesterinscreening bei Kindern: Resultate einer neunjährigen Längsschnittuntersuchung von Schweizer- un Italienerkindern in der Schweiz

Les screening du cholestérol chez les enfants: Les résultats dúne étude longitutinale d'enfants suisses et immigrés en Suisse sur la période de 9 ans

  • Published:
Sozial- und Präventivmedizin

Summary

Mass screening for blood cholesterol as part of routine preventive health care of children continues to be discussed in several countries. Results of longitudinal studies underline the importance of the predictive value of cholesterol levels assessed during childhood. Some countries have changed their recommendations during the past years to blood cholesterol screening for obese children only or for children of high risk families. In the Kindergarten-study Basel, a follow-up study on somatic, psychic and social development of Swiss and immigrant schoolchildren, cardiovascular risk factors were assessed at the ages of 5, 10 and 14 years. The age-specific levels of total and LDL-cholesterol found in our study were slightly higher and HDL-cholesterol lower than, for example, those found in the Bogalusa Heart Study. For total cholesterol no significant tracking correlations over the 5 and 9 year periods were found. Tracking of LDL- and HDL-cholesterol differed between nationalities and sexes. The total cholesterol/HDL-cholesterol index tracked slightly better. Italian girls showed the best 9-year tracking for HDL-cholesterol (r=0.56). The differences between this and other studies can only partially be explained by different sampling and laboratory methods. Individual changes in cholesterol levels between the ages of 5 and 14 were marked. Sexual maturation was found to be of minor influence. Body mass index was the most consistent risk factor in our population. Changes of sex or growth hormone levels during puberty, but also changes of nutritional habits or physical activity might influence the individual cholesterol levels. Before recommendations on mass screening of cholesterol in children are made, the different longitudinal patterns of changes in cholesterol levels, and subpopulation-specific changes of nutritional habits and physical activity, should be discussed. The results of the Kindergarten-study Basel suggest that attention should be paid to screening for obesity and to health education regarding nutrition and physical activity.

Résumé

On continue de discuter le screening du cholestérol chez les enfants. Différents pays ont changé au courrant des dernières années leur attitude vis-à-vis du screening, en le limitant, aux enfants obèses ou appartenant à des familles à haut risque. Dans notre étude longitudinale sur le développement somatique, psychique et social d'enfants suisses et immigrés en âge scolaire, les facteurs de risque cardiovasculaires ont été analysés à l'âge de 5, 10 et 14 ans. Pour le cholestérol total, aucune corrélation de tracking tout au long des périodes de 5 et 9 ans a été trouvée. La corrélation de tracking du cholestérol LDL et HDL par contre a montré des différences de niveau par nationalité et par sexe. Les différences trouvées par rapport à d'autres études ne s'expliquent qu'en partie par les différences dans les populations ou par les méthodes de laboratoire. L'étude a trouvé en outre des différences individuelles considérables dans le niveau de cholestérol entre l'âge de 5 et celui de 14 ans. Le body-mass-index était plus constant. Non seulement la puberté, mais également les changements des habitudes alimentaires ou de l'activité physique-specifique dans les subpopulations-peuvent exercer une influence sur le niveau individuel de cholestérol. Les résultats de l'étude bâloise soulignent l'importance du screening d'obésité et de la promotion de la santé dans les domaines de l'alimentation et du sport.

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Authors and Affiliations

  1. Department for Social and Preventive Medicine, University of Basel, Steinengraben 49, CH-4051, Basel

    Beat Mohler, Ursula Ackermann-Liebrich & Thomas Steffen

  2. University Hospital, Basel

    Hannes B. Staehelin

Authors
  1. Beat Mohler
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  2. Ursula Ackermann-Liebrich
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  3. Thomas Steffen
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  4. Hannes B. Staehelin
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Mohler, B., Ackermann-Liebrich, U., Steffen, T. et al. Cholesterol screening in childhood: Results of a 9-year follow-up study in Swiss and Italian children in Switzerland. Soz Präventivmed 41, 333–340 (1996). https://doi.org/10.1007/BF01324282

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