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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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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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
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ABSTRACT: Objective. To evaluate the effect of a family-based intervention on anthropometric and metabolic markers in overweight and obese children. Methods. Overweight or obese 8–12 years olds (n = 93) were randomized into intervention or control groups. The intervention group participated in a program aiming for lifestyle changes regarding food habits and physical activity. Anthropometric measures and venous blood samples were collected from all children at baseline and after 1 year. Results. BMI z-scores decreased in both groups, 0.22 (P = 0.002) and 0.23 (P = 0.003) in intervention and control group, respectively, during the 1-year study, but there was no difference in BMI between the groups at 1-year measurement (P = 0.338). After 1 year, there was a significant difference in waist circumference, waist/hip ratio, and apolipoprotein B/A1 ratio between intervention and control group. Conclusions. The intervention had limited effects on anthropometrics and metabolic markers, which emphasizes the need of preventing childhood overweight and obesity.Journal of nutrition and metabolism 01/2012; 2012:913965. DOI:10.1155/2012/913965