Skinner Asheley Cockrell, Steiner Michael J, Chung Arlene E, Perrin Eliana M
The University of North Carolina at Chapel Hill, NC 27599, USA.
Clin Pediatr (Phila). 2012 Mar;51(3):233-7. doi: 10.1177/0009922811430344. Epub 2011 Dec 8.
Develop clinically applicable charts of lipid values illustrating fluctuations throughout childhood and by sex among healthy weight children.
The National Health and Nutrition Examination Survey (1999-2008) was used to estimate total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides by age and sex in healthy weight children age 3 to 17 years. Using LMS procedures, the authors created smoothed curves demonstrating population-based 50th percentile for age and the 75th and 95th percentiles.
The curves were based on 7681 children meeting inclusion criteria. Total cholesterol, HDL, and LDL demonstrated peaks at approximately 8 to 12 years for boys. Similar peaks were evident for girls at slightly younger ages, approximately 7 to 11 years. Triglycerides showed peaks for girls, but values were similar across ages for boys.
The use of fixed lipid value cutoffs in established guidelines regardless of age or sex likely mislabels many children as abnormal. The authors' charts may allow for a more nuanced interpretation based on population norms.
绘制临床适用的血脂值图表，展示健康体重儿童在整个童年时期的波动情况以及按性别划分的情况。
利用国家健康与营养检查调查（1999 - 2008年）的数据，估算3至17岁健康体重儿童按年龄和性别的总胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）和甘油三酯水平。作者采用LMS方法创建了平滑曲线，展示了基于人群的年龄第50百分位数以及第75和第95百分位数。
这些曲线基于7681名符合纳入标准的儿童。男孩的总胆固醇、HDL和LDL在大约8至12岁时出现峰值。女孩在稍小年龄（约7至11岁）时也有类似峰值。甘油三酯在女孩中出现峰值，但男孩各年龄组的值相似。
既定指南中使用固定的血脂值临界值，而不考虑年龄或性别，可能会将许多儿童错误地判定为异常。作者的图表可能有助于根据人群标准进行更细致入微的解读。
