Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (2): 217-221. doi: 10.19723/j.issn.1671-167X.2022.02.003

Previous Articles     Next Articles

Incidence and cause of abnormal cholesterol in children aged 2-18 years in a single center

YAN Hui1,PANG Lu2,LI Xue-ying3,YANG Wen-shuang2,JIANG Shi-ju2,LIU Ping1,YAN Cun-ling2,()   

  1. 1. Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
    2. Department of Laboratory, Peking University First Hospital, Beijing 100034, China
    3. Department of Statistics, Peking University First Hospital, Beijing 100034, China
  • Received:2020-09-07 Online:2022-04-18 Published:2022-04-13
  • Contact: Cun-ling YAN E-mail:yancunling@163.com

RICH HTML

  

Abstract:

Objective: To investigate the abnormality and distribution of plasma cholesterol levels in single-center hospitalized children. Methods: The blood lipid levels of children aged 2-18 years who had blood lipid test results in Peking University First Hospital from June 2016 to June 2019 were etrospectively analyzed. Cholesterol oxidase method was used for total cholesterol, and high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were detected by clearance method. The counting data were compared with chi-square test. Results: The survey had involved 11 829 children (7 087 were boys and 4 742 were girls). 1 822 (15.4%) children were with elevated total cholesterol, 1 371 (11.6%) children with elevated low-density lipoprotein cholesterol, and 2 798 (23.7%) children with high-density lipoprotein cholesterol reduction. The total number of the children with abnormal cholesterol levels was 4 427 (37.4%). Among the 7 835 children who visited hospital due to the disease not commonly inducing dyslipidemia, 731 (9.3%) had elevated TC, 561 (7.2%) had elevated LDL-C, 1 886 (24.1%) had decreased HDL-C, and 2 576 (32.9%) had abnormal cholesterol levels. Among the children with different diseases, the difference in the incidence of abnormal cholesterol was statistically significant. The top three main groups of the children with increased total cholesterol and low-density lipoprotein cholesterol were “dyslipidemia”, “urinary tract disease”, and “nutritional disease”; The top three main groups of the children with reduced high-density lipoprotein cholesterol were “respiratory diseases”, “dyslipidemia”, “hematological diseases and malignant tumors”. Among the 1 257 blood li-pid test results sent by other departments, 300 cases had abnormal cholesterol levels (23.8%). Among them, there were 70 children with hypercholesterolemia (5.6%), 44 children with increased low-density lipoprotein cholesterol (3.5%), and 224 children with reduced high-density lipoprotein cholesterol (17.8%). There were 365 (4.6%) children with low-density lipoprotein cholesterol ≥140 mg/dL (3.6 mmol/L) who needed to further exclude familiar hypercholesterolemia among the children who visited hospitals due to the disease not commonly inducing dyslipidemia. Conclusion: Children in hospitals have a high incidence of cholesterol abnormalities. Doctors need to pay more attention to the cholesterol diagnosis and management regardless of the discipline, which not only helps to control secondary hypercholesterolemia, but also provides the possibility of detecting familial hypercholesterolemia in time.

Key words: Hypercholesterolemia, Dyslipidemia, Screen, Children

CLC Number: 

  • R725.4

Table 1

Abnormal cholesterol levels in different groups of the diseases"

Disease classification n TC≥5.18 mmol/L,
n (%)
LDL-C≥
3.37 mmol/L, n (%)
HDL-C≤
1.04 mmol/L, n (%)
Cholesterol level
abnormal, n (%)
Cholesterol level
normal, n (%)
Dyslipidemia 25 11 (44.0) 11 (44.0) 11 (44.0) 17 (68.0) 8 (32.0)
Nutritional diseases 107 17 (15.9) 12 (11.2) 33 (30.8) 47 (43.9) 60 (56.1)
Respiratory diseases 395 15 (3.8) 19 (4.8) 194 (49.1) 210 (53.2) 185 (46.8)
Digestive system
diseases
334 24 (7.2) 26 (7.8) 82 (24.6) 106 (31.7) 228 (68.3)
Urinary system
diseases
2 659 954 (35.9) 712 (26.8) 522 (19.6) 1 350 (50.8) 1 309 (49.2)
Nervous system
disease
2 555 272 (10.7) 194 (7.6) 529 (20.7) 781 (30.6) 1 774 (69.4)
Cardiovascular diseases 833 67 (8.0) 48 (5.8) 211 (25.3) 277 (33.3) 556 (66.7)
Definitively diagnosed
metabolic diseases and
mitochondrial diseases
683 63 (9.2) 47 (6.9) 186 (27.2) 239 (35.0) 444 (65.0)
Endocrine disease 190 16 (8.4) 11 (5.8) 56 (29.5) 70 (36.8) 120 (63.2)
Immune system
diseases
138 13 (9.4) 8 (5.8) 42 (30.4) 51 (37.0) 87 (63.0)
Blood system diseases
and malignant tumors
324 45 (13.9) 32 (9.9) 106 (32.7) 141 (43.5) 183 (56.5)
Others 1 470 87 (5.9) 72 (4.9) 302 (20.5) 393 (26.7) 1 077 (73.3)
Unknown diagnosis 716 62 (8.7) 39 (5.4) 159 (22.2) 218 (30.5) 498 (69.6)
Unwritten diagnosis 1 400 176 (12.6) 140 (10.0) 365 (26.1) 527 (37.6) 873 (62.4)
Total 11 829 1 822 (15.40) 1 371 (11.6) 2 798 (23.7) 4 427 (37.4) 7 402 (62.6)
[1] 中华医学会儿科学分会儿童保健学组, 中华医学会儿科学分会心血管学组, 中华医学会心血管病学分会动脉粥样硬化学组, 等. 儿童青少年血脂异常防治专家共识[J]. 中华儿科杂志, 2009, 47(6):426-428.
[2] Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adole-scents: summary report[J]. Pediatrics, 2011, 128(Suppl 5):213-256.
[3] American Academy of Pediatrics. Committee on Nutrition. American Academy of Pediatrics. Committee on Nutrition. Cholesterol in childhood[J]. Pediatrics, 1998, 101(1 Pt 1):141-147.
doi: 10.1542/peds.101.1.141
[4] Okada T, Murata M, Yamauchi K, et al. New criteria of normal serum lipid levels in Japanese children: the nationwide study[J]. Pediatr Int, 2002, 44(6):596-601.
doi: 10.1046/j.1442-200X.2002.01634.x
[5] Harada-Shiba M, Ohta T, Ohtake A, et al. Guidance for pediatric familial hypercholesterolemia 2017[J]. J Atheroscler Thromb, 2018, 25(6):539-553.
doi: 10.5551/jat.CR002 pmid: 29415907
[6] Rallidis L, Naoumova RP, Thompson GR, et al. Extent and severity of atherosclerotic involvement of the aortic valve and root in familial hypercholesterolaemia[J]. Heart, 1998, 80(6):583-590.
pmid: 10065027
[7] Bornaun H, Öner N, Nişli K, et al. Assessment of lipid profile and some risk factors of atherosclerosis in children whose parents had early onset coronary artery disease[J]. Arch Argent Pediatr, 2017, 115(1):50-54.
doi: 10.5546/aap.2017.eng.50 pmid: 28097840
[8] Hingorani AD, Futema M, Humphries S. Child-parent familial hypercholesterolemia screening in primary care[J]. N Engl J Med, 2017, 376(5):499-500.
[9] Filgueiras MS, Vieira SA, Ribeiro AQ, et al. Family history is associated with the presence of pre-school children[J]. Rev Paul Pediatr, 2019, 37(1):41-48.
doi: 10.1590/1984-0462/;2019;37;1;00005
[10] Ahmad ZS, Andersen RL, Andersen LH, et al. US physician practices for diagnosing familial hypercholesterolemia: data from the CASCADE-FH registry[J]. J Clin Lipidol, 2016, 10(5):1223-1229.
doi: 10.1016/j.jacl.2016.07.011
[11] Ding W, Cheng H, Yan Y, et al. 10-year trends in serum lipid levels and dyslipidemia among children and adolescents from several schools in Beijing, China[J]. J Epidemiol, 2016, 26(12):637-645.
doi: 10.2188/jea.JE20140252
[12] Kouda K, Iki M, Fujita Y, et al. Trends in serum lipid levels of a 10- and 13-year-old population in Fukuroi City, Japan (2007—2017)[J]. J Epidemiol, 2020, 30(1):24-29.
doi: 10.2188/jea.JE20180164
[13] 王政和, 邹志勇, 阳益德, 等. 2012年中国7省份6~17岁儿童青少年血脂异常流行情况及相关因素分析[J]. 中华预防医学杂志, 2018, 52(8):798-801.
[14] Pratt RE, Kavey RE, Quinzi D. Combined dyslipidemia in obese children: response to a focused lifestyle approach[J]. J Clin Lipidol, 2014, 8(2):181-186.
doi: 10.1016/j.jacl.2014.01.003
[15] Dowla S, Aslibekyan S, Goss A, et al. Dyslipidemia is associated with pediatric nonalcoholic fatty liver disease[J]. J Clin Lipidol, 2018, 12(4):981-987.
doi: 10.1016/j.jacl.2018.03.089
[16] Wiegman A, Gidding SS, Watts GF, et al. Familial hypercholesterolaemia in children and adolescents: gaining decades of life by optimizing detection and treatment[J]. Eur Heart J, 2015, 36(36):2425-2437.
doi: 10.1093/eurheartj/ehv157 pmid: 26009596
[17] Robinson JG. Management of familial hypercholesterolemia: a review of the recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia[J]. J Manag Care Pharm, 2013, 19(2):139-149.
[1] Xiuwen FEI,Si LIU,Bo WANG,Aimei DONG. Clinical characteristics and treatment in adults and children with histiocytic necroti-zing lymphadenitis [J]. Journal of Peking University (Health Sciences), 2024, 56(3): 533-540.
[2] Qi WU,Yue-ming CAI,Juan HE,Wen-di HUANG,Qing-wen WANG. Correlation between dyslipidemia and rheumatoid arthritis associated interstitial lung disease [J]. Journal of Peking University (Health Sciences), 2023, 55(6): 982-992.
[3] Xiao-jin YAN,Yun-fei LIU,Ning MA,Jia-jia DANG,Jing-shu ZHANG,Pan-liang ZHONG,Pei-jin HU,Yi SONG,Jun MA. Assessment of prevalence of malnutrition among Chinese primary and secondary school students and analysis of policy effect during the period of the Program for the Development of Chinese Children 2011-2020 [J]. Journal of Peking University (Health Sciences), 2023, 55(4): 593-599.
[4] Xiao-yi MI,Shan-shan HOU,Zi-yuan FU,Mo ZHOU,Xin-xuan LI,Zhao-xue MENG,Hua-fang JIANG,Hong Zhou. Reliability and validity of the Chinese version of adverse childhood experiences international questionnaire in parents of preschool children [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 408-414.
[5] Meng-jie CUI,Qi MA,Man-man CHEN,Tao MA,Xin-xin WANG,Jie-yu LIU,Yi ZHANG,Li CHEN,Jia-nuo JIANG,Wen YUAN,Tong-jun GUO,Yan-hui DONG,Jun MA,Yi XING. Association between different growth patterns and metabolic syndrome in children and adolescents aged 7 to 17 years [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 415-420.
[6] Jia-jia DANG,Shan CAI,Pan-liang ZHONG,Ya-qi WANG,Yun-fei LIU,Di SHI,Zi-yue CHEN,Yi-hang ZHANG,Pei-jin HU,Jing LI,Jun MA,Yi SONG. Association of outdoor artificial light at night exposure with overweight and obesity among children and adolescents aged 9 to 18 years in China [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 421-428.
[7] Ya-xi CUI,Jun-bao DU,Qing-you ZHANG,Ying LIAO,Ping LIU,Yu-li WANG,Jian-guang QI,Hui YAN,Wen-rui XU,Xue-qin LIU,Yan SUN,Chu-fan SUN,Chun-yu ZHANG,Yong-hong CHEN,Hong-fang JIN. A 10-year retrospective analysis of spectrums and treatment options of orthostatic intolerance and sitting intolerance in children [J]. Journal of Peking University (Health Sciences), 2022, 54(5): 954-960.
[8] Tao MA,Yan-hui LI,Man-man CHEN,Ying MA,Di GAO,Li CHEN,Qi MA,Yi ZHANG,Jie-yu LIU,Xin-xin WANG,Yan-hui DONG,Jun MA. Associations between early onset of puberty and obesity types in children: Based on both the cross-sectional study and cohort study [J]. Journal of Peking University (Health Sciences), 2022, 54(5): 961-970.
[9] Jia-min WANG,Qiu-ping LIU,Ming-lu ZHANG,Chao GONG,Shu-dan LIU,Wei-ye CHEN,Peng SHEN,Hong-bo LIN,Pei GAO,Xun TANG. Effectiveness of different screening strategies for type 2 diabete on preventing cardiovascular diseases in a community-based Chinese population using a decision-analytic Markov model [J]. Journal of Peking University (Health Sciences), 2022, 54(3): 450-457.
[10] LIU Qiu-ping,CHEN Xi-jin,WANG Jia-min,LIU Xiao-fei,SI Ya-qin,LIANG Jing-yuan,SHEN Peng,LIN Hong-bo,TANG Xun,GAO Pei. Effectiveness of different screening strategies for cardiovascular diseases prevention in a community-based Chinese population: A decision-analytic Markov model [J]. Journal of Peking University (Health Sciences), 2021, 53(3): 460-466.
[11] CHEN Man-man,YANG Zhao-geng,SU Bin-bin,LI Yan-hui,GAO Di,MA Ying,MA Tao,DONG Yan-hui,MA Jun. Analysis on the law of height growth spurt in adolescence of children and adolescents in Zhongshan City [J]. Journal of Peking University (Health Sciences), 2021, 53(3): 506-510.
[12] Chun-yan TAO,Hong-xia LI,Xue-ying LI,Chao-shu TANG,Hong-fang JIN,Jun-bao DU. Hemodynamic changes in standing-up test of children and adolescents with postural tachycardia syndrome [J]. Journal of Peking University(Health Sciences), 2019, 51(3): 414-421.
[13] Le GAO,Shu-qing YU,Ji-chun YANG,Jun-ling MA,Si-yan ZHAN,Feng SUN. Quality assessment of global guidelines on colorectal cancer screening [J]. Journal of Peking University(Health Sciences), 2019, 51(3): 548-555.
[14] WU Peng-hui, XIE Yao, ZHAO Wei-hong, HUA Ying, SUN Qing, LI Shuo, WU Ye, LU Xin-tian. Clinical characteristics analysis of children with reversible posterior leukoen-cephalopathy syndrome during the treatment of hematological tumor [J]. Journal of Peking University(Health Sciences), 2018, 50(4): 662-665.
[15] LU Jin-hui, QIAN Jun, LIU He, ZHU Jun-xia. Clinical study on autologus platelet-rich fibrin aided revascularization of immature permanent teeth [J]. Journal of Peking University(Health Sciences), 2018, 50(4): 672-679.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!