Committee on Nutrition. Lipid screening and cardiovascular health in childhood
ABSTRACT This clinical report replaces the 1998 policy statement from the American Academy of Pediatrics on cholesterol in childhood, which has been retired. This report has taken on new urgency given the current epidemic of childhood obesity with the subsequent increasing risk of type 2 diabetes mellitus, hypertension, and cardiovascular disease in older children and adults. The approach to screening children and adolescents with a fasting lipid profile remains a targeted approach. Overweight children belong to a special risk category of children and are in need of cholesterol screening regardless of family history or other risk factors. This report reemphasizes the need for prevention of cardiovascular disease by following Dietary Guidelines for Americans and increasing physical activity and also includes a review of the pharmacologic agents and indications for treating dyslipidemia in children.
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- "Abnormal lipid levels in the young have been shown to be associated with increased risk of early CVD ( Berenson et al . , 1998 ; Daniels and Greer , 2008 ) and are a target for initiating phar - macological treatment ( Stein , 1989 ) . However , unlike in adults , there is limited available research into the role of environmental PFAS exposure and dyslipidemia in children and adolescents . "
ABSTRACT: Dyslipidemia in children is associated with accelerated atherosclerosis and earlier cardiovascular disease development. Environmental exposure to perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) have been shown to be associated with dyslipidemia in adults. However, there are few general population studies examining this association in children or adolescents. In this context, we examined the association between serum PFOA and PFOS levels and dyslipidemia in a nationally representative sample of US adolescents. A cross-sectional study was performed on 815 participants ⩽18years of age from the National Health and Nutrition Examination Survey 1999-2008. The main outcome was dyslipidemia, defined as total cholesterol >170mg/dL, low-density lipoprotein cholesterol (LDL-C) >110mg/dL, high-density lipoprotein cholesterol (HDL-C) <40mg/dL or triglycerides >150mg/dL. We found that serum PFOA and PFOS were positively associated with high total cholesterol and LDL-C, independent of age, sex, race-ethnicity, body mass index, annual household income, physical activity and serum cotinine levels. Compared to subjects in quartile 1 (referent), the multivariable-adjusted odds ratio (95% confidence interval) for high total cholesterol among children in quartile 4 was 1.16 (1.05-2.12) for PFOA and 1.53 (1.11-1.64) for PFOS. PFOA and PFOS were not significantly associated with abnormal HDL-C and triglyceride levels. Our findings indicate that serum PFOA and PFOS are significantly associated with dyslipidemia in adolescents, even at the lower "background" exposure levels of the US general population.Chemosphere 11/2013; 98. DOI:10.1016/j.chemosphere.2013.10.005 · 3.50 Impact Factor
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- "Pediatrics (AAP), American Heart Association (AHA), and National Heart, Lung, and Blood Institute (Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, 2011; Daniels et al., 2008; Weintraub et al., 2011). However, lipid levels change with age, puberty, race, and gender among children and adolescents (Hickman et al., 1998). "
ABSTRACT: Abstract Cardiovascular risk factors and atherosclerosis precursors were examined in 365 Turkish children and adolescents. Study participants were recruited at five different state schools. We tested single and multi-locus effects of six polymorphisms from five candidate genes, chosen based on prior known association with lipid levels in adults, for association with low (≤10(th) percentile) high density lipoprotein cholesterol (HDL-C) and high (≥90(th) percentile) triglycerides (TG), and the related continuous outcomes. We observed an association between CETP variant rs708272 and low HDL-C (allelic p=0.020, genotypic p=0.046), which was supported by an independent analysis, PRAT (PRAT control p=0.027). Sex-stratified logistic regression analysis showed that the B2 allele of rs708272 decreased odds of being in the lower tenth percentile of HDL-C measurements (OR=0.36, p=0.02) in girls; this direction of effect was also seen in boys but was not significant (OR=0.64, p=0.21). Logistic regression analysis also revealed that the T allele of rs6257 (SHBG) decreased odds of being in the top tenth percentile of TG measurements in boys (OR=0.43, p=0.03). Analysis of lipid levels as a continuous trait revealed a significant association between rs708272 (CETP) and LDL-C levels in males (p=0.02) with the B2B2 genotype group having the lowest mean LDL-C; the same direction of effect was also seen in females (p=0.05). An effect was also seen between rs708272 and HDL-C levels in girls (p=0.01), with the B2B2 genotype having the highest mean HDL-C levels. Multi-locus analysis, using quantitative multifactor dimensionality reduction (qMDR) identified the previously mentioned CETP variant as the best single locus model, and overall model, for predicting HDL-C levels in children. This study provides evidence for association between CETP and low HDL-C phenotype in children, but the results appear to be weaker in children than previous results in adults and may also be subject to gender effects.Omics: a journal of integrative biology 08/2013; 17. DOI:10.1089/omi.2013.0066 · 2.73 Impact Factor
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- "Patients were excluded from the study if they were below the age of 2 years or above the age of 18 years at the time of HSCT. Lipoproteins reach concentrations similar to those in young adults by the age of 2 years, and equivalent lipid panel values are used for children aged 2 to 18 years (Daniels & Greer, 2008). Children were also excluded from the study if they received an autologous HSCT or if they did not complete a lipid panel as part of their annual evaluation testing at the pediatric teaching hospital. "
ABSTRACT: Cardiovascular disease (CVD) is the leading cause of death among adults in the United States. CVD pathology, including abnormal lipid levels, may begin in childhood. Hematopoietic stem cell transplant (HSCT) survivors have increased risk of abnormal lipid levels, but there is limited information in children post-HSCT. The study aimed to describe lipid levels and identify the factors associated with dyslipidemia in pediatric HSCT survivors during the first 3 years post-HSCT. This descriptive research study used a retrospective chart review to assess lipid profiles among 31 pediatric HSCT patients. Mean lipid levels were within normal limits but contained large ranges in values. There was no statistically significant change over time; however, there was an increased trend of total cholesterol and low-density lipoprotein levels and a decreased trend of high-density lipoprotein levels. The majority of patients had one abnormal lipid level at 1 and 2 years post-HSCT. Body mass index was the only factor significantly associated with dyslipidemia. An awareness of dyslipidemia among HSCT survivors may allow for early identification and treatment of abnormal lipid levels.Journal of Pediatric Oncology Nursing 03/2012; 29(2):63-9. DOI:10.1177/1043454212438404 · 0.87 Impact Factor