Cholesterol and lipoprotein levels in Milanese children: relation to nutritional and familial factors

Blood Cholesterol and Triglycerides in Adolescent Egyptian Girls: Relation to Anthropometric Measurements

High serum cholesterol is a major risk factor for atherosclerosis. This cross-sectional study (n = 102) investigated the levels of total cholesterol (TC) and triglycerides (TG) in Egyptian girls aged 11 to 16 years attending a middle-class public school. The mean TC level was 194.27 ± 21.97 mg/dl, and 33.33% of girls had TC levels > 200 mg/dl. The mean TG level was 160.07 ± 30.83 mg/dl, with 3.92% of the girls showing TG levels > 2 00 mg/dl. Most of the girls (65.69%) were overweight, with body mass index (BMI) >25. Univariate analyses revealed an association of TC and TG with all anthropometric measures. Using stepwise regression analyses, the best model for prediction of TC was with BMI and central body fat (explaining 24.76% of TC variance); the final model for TG was with BMI, central body fat, and abdominal skinfold thickness (explaining 47.49% of TG variance). Our data show that these adolescent Egyptian girls were heavier and had higher blood lipid concentrations than subjects in the Bogalusa study and other studies worldwide. Further studies are needed to determine the factors associated with these higher lipid levels and to develop appropriate intervention programmes.

Screening and treatment for lipid disorders in children and adolescents: systematic evidence review for the US Preventive Services Task Force

OBJECTIVE

This was a systematic evidence review for the US Preventive Services Task Force, intended to synthesize the published evidence regarding the effectiveness of selecting, testing, and managing children and adolescents with dyslipidemia in the course of routine primary care.

METHODS

Literature searches were performed to identify published articles that addressed 10 key questions. The review focused on screening relevant to primary care of children without previously identified dyslipidemias, but included treatment trials of children with dyslipidemia because some drugs have only been tested in that population.

RESULTS

Normal values for lipids for children and adolescents are defined according to population levels (percentiles). Age, gender, and racial differences and temporal trends may alter these statistical cut points. Approximately 40% to 55% of children with elevated total cholesterol and low-density lipoprotein levels will continue to have elevated lipid levels on follow-up. Current screening recommendations based on family history will fail to detect substantial numbers (30%-60%) of children with elevated lipid levels. Drug treatment for dyslipidemia in children has been studied and shown to be effective only for suspected or proven familial monogenic dyslipidemias. Intensive dietary counseling and follow-up can result in improvements in lipid levels, but these results have not been sustained after the cessation of the intervention. The few trials of exercise are of fair-to-poor quality and show little or no improvements in lipid levels for children without monogenic dyslipidemias. Although reported adverse effects were not serious, studies were generally small and not of sufficient duration to determine long-term effects of either short or extended use.

CONCLUSIONS

Several key issues about screening and treatment of dyslipidemia in children and adolescents could not be addressed because of lack of studies, including effectiveness of screening on adult coronary heart disease or lipid outcomes, optimal ages and intervals for screening children, or effects of treatment of childhood lipid levels on adult coronary heart disease outcomes.

Adipose fat quality vs. quantity: relationships with children's serum lipid levels

BACKGROUND

There is a controversy as to the relative importance of obesity vs quality of dietary fat in the prediction of serum lipoproteins in children. A reason for this is an apparent lack of studies implementing biomarkers of long-term dietary fat intake among children. The objective of the present study was to assess the relative contribution of degree of obesity, fat centrality, and quality of adipose tissue fat in the prediction of serum lipids in 12-year-old children.

METHODS

Pupils came from 40 schools randomly selected among 541 primary schools in three different provinces of the island of Crete. One thousand forty-six pupils were examined at age 6. At age 9, a representative sample from the original cohort (n = 579) was randomly selected for reevaluation. At the age of 12, a representative sample of 831 pupils was reexamined. At ages 6, 9, and 12, serum lipid measures were obtained from 941, 458, and 791 children, respectively. At age 12, data were obtained on pupils' anthropometry, serum lipids, dietary intake, physical fitness, and physical activity. Adipose tissue fatty acid data were obtained from a subsample of 194 children at age 12.

RESULTS

Regression analyses indicated that children's serum triglycerides related positively to body mass index and waist-hip ratio (WHR). Serum HDL-C related negatively to WHR and positively to endurance run test, an index of physical fitness. Dietary fatty acids, assessed by a single administration of 3-day weighed-food records, did not relate to serum lipids. However, serum HDL-C related negatively to sum of adipose polyunsaturated fatty acids, a measure of long-term polyunsaturated fat intake.

CONCLUSIONS

It appears that obesity and fat centrality are stronger predictors of children's serum lipids than the quality of long-term dietary fat intake or adipose tissue fatty acid composition. It is possible that this finding may relate to the particular subcutaneous depot studied. It is suggested that future studies study abdominal rather than buttock adipose tissue fatty acid composition in relation to children's serum lipid levels.

Relationship between stroke and asymptomatic minute hemorrhages in hypertensive patients

Asymptomatic small hemorrhages were identified in hypertensive patients by T2*-weighted gradient echo magnetic resonance (MR) imaging to investigate the relationship between hypertensive intracerebral hemorrhage and asymptomatic minute hemorrhages. Forty-eight patients with hypertensive intracerebral hemorrhage or cerebral infarction with hypertension (these diseases were defined as stroke) were treated in National Defense Medical College from April 1998 to February 2000. All patients had no past history of stroke or head injury, underwent MR imaging within 6 months of the stroke attack, were aged from 40 to 80 years, and had no diagnosis of aneurysm, angioma, or moyamoya disease. Patients were divided into the infarction group and hemorrhage group. All foci over 2 mm in size appearing as hypointense on T2*-weighted MR imaging and unrelated to stroke areas were defined as minute hemorrhages. There were no significant differences between the two groups with respect to sex, age, and history of diabetes mellitus. The incidence of minute hemorrhages in the hemorrhage group (21/26) was greater than in the infarction group (9/22, p < 0.01). The incidence of minute hemorrhages in the basal ganglia (18/26) was greater in the hemorrhage group than in the infarction group (4/22, p < 0.001). Symptomatic intracerebral hemorrhage may be preceded by asymptomatic minute hemorrhage.

Comparison of selected nutritional indicators in children in Slovakia in 1988 and 1992

Selected indicators of nutritional status in children and adolescents assessed in 1988 and 1992 were compared in relation to changed food consumption trends caused by liberalization of food prices. In 1992, 1507 individuals aged 11-18 years were examined and the results were compared with those of children and adolescents of the same age group examined in 1988. Negative changes in food habits are probably the cause of persisting high levels of serum lipids and increasing frequency of hypoascorbinaemia.