Low HDL-C: increasing problem in adolescents

One in five adolescents has abnormal lipids, with low HDL cholesterol accounting for over one-third of abnormal values, according to new data from the National Health and Nutrition Examination Survey (NHANES). The implications of these data are discussed here by Professor Philip Barter, HDL Forum Editor, from the Heart Research Institute, Sydney, Australia.

 Centers for Disease Control and Prevention. Prevalence of abnormal lipid levels among youths – United States, 1999-2006. MMWR Morb Mortal Wkly Rep 2010; 59:29-31.

Editorial note. MMWR Morb Mortal Wkly Rep 2010; 59:31-32.

Both are available here www.cdc.gov/mmwr/preview.mmwrhtml/mm5902a1.htm.

 This latest NHANES report was based on data collected over the last four survey cycles, 1999-2006. The survey included 9,187 adolescents aged 12-19 years, of whom 3,125 had evaluable lipid data. Lipid levels were classified according to the National Cholesterol Education Program Adult Treatment Panel III/American Heart Association limits:

 Low HDL cholesterol <35 mg/dL

High LDL cholesterol >130 mg/dL

Elevated triglycerides >150 mg/dL

 The survey showed that low HDL cholesterol was more common in boys than girls (11% vs. 4%), consistent with other findings that have reported higher HDL levels in girls than boys post-puberty (1).  Importantly, in the overweight or obese, low HDL cholesterol was detected in 8.3% and 20.5% of participants.

 In an accompanying editorial, the CDC urges clinicians to be aware of the lipid screening guidelines so that interventions for overweight or obese children and youths can be recommended.

 Commenting on these findings, Professor Barter said: ‘With escalating rates of obesity world-wide, dyslipidemia is a problem not only among adults but also increasingly children and adolescents. As reported here by the CDC, low HDL cholesterol is prevalent in Western developed societies. However, studies also show an increasing prevalence of low HDL cholesterol among children in countries such as China (2). Given that untreated abnormal lipid levels during childhood and adolescence confer an increased risk for cardiovascular disease in adult life (3), these findings underline the importance of targeted lipid screening in adolescents, especially the overweight/obese.’

 References

1. Dai S, Fulton JE, Harris RB et al. Blood lipids in children: age-related patterns and association with body-fat indices: Project HeartBeart! Am J Prev Med 2009;37(suppl):S56-64.

2. Zhang C-X, Tse L-A, Deng X-Q, Jiang Z-Q. Cardiovascular risk factors in overweight and obese Chinese children. Eur J Nutr 2008;47:244-250.

3. Daniels SR, Greer FR. Lipid screening and cardiovascular health in childhood. Pediatrics 2008;122:198-208.

 


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