Wong N D, Hei T K, Qaqundah P Y, Davidson D M, Bassin S L, Gold K V
Preventive Cardiology Program, University of California, Irvine 92717.
Pediatrics. 1992 Jul;90(1 Pt 1):75-9.
Cholesterol screening for children is recommended currently only for those with a family history of premature coronary heart disease or hyperlipidemia. The authors report on a pediatric-office-based cholesterol screening program where the predictive values of family history indicators were evaluated along with reported television viewing, physical activity, and dietary habits in 1081 children (aged 2 to 20 years, mean 7.4 +/- 3.6 [SD] years). Eight percent of these children had a total cholesterol value of 200 mg/dL or higher; 53% of such children reported watching 2 or more hours of television daily compared with 34% of children with lower cholesterol levels. Multivariate analyses revealed that excessive television viewing was the strongest predictor for a child to have a cholesterol value of 200 mg/dL or higher, with relative risks of 2.2 for 2 to 4 hours of television viewing per day (P less than .01) and 4.8 for children watching more than 4 hours/day, when compared to those watching less than 2 hours/day (P less than .01). In contrast, a positive family history of a high cholesterol level was only modestly associated with an increased probability of having a high cholesterol level (relative risk = 1.6, P less than .05), and a history of premature myocardial infarction in a parent or grandparent was not associated with a child's cholesterol level. Excessive television viewing was found to be associated with certain dietary and physical activity habits and may prove to be a useful, global marker for several life-style factors predisposing children to hypercholesterolemia.
目前，仅建议对有早发性冠心病或高脂血症家族史的儿童进行胆固醇筛查。作者报告了一项基于儿科诊所的胆固醇筛查项目，该项目对1081名儿童（年龄2至20岁，平均7.4±3.6[标准差]岁）的家族史指标预测值以及报告的电视观看时间、身体活动和饮食习惯进行了评估。这些儿童中有8%的总胆固醇值达到或高于200mg/dL；此类儿童中有53%报告每天看电视2小时或更长时间，而胆固醇水平较低的儿童这一比例为34%。多变量分析显示，过度看电视是儿童胆固醇值达到或高于200mg/dL的最强预测因素，与每天看电视2至4小时的儿童相比，相对风险为2.2（P<0.01），与每天看电视超过4小时的儿童相比，相对风险为4.8（P<0.01），而与每天看电视少于2小时的儿童相比。相比之下，高胆固醇水平的阳性家族史与高胆固醇水平增加的可能性仅呈适度关联（相对风险=1.6，P<0.05），父母或祖父母有过早心肌梗死病史与儿童胆固醇水平无关。研究发现，过度看电视与某些饮食和身体活动习惯有关，可能被证明是预测儿童易患高胆固醇血症的几种生活方式因素的有用综合指标。
