Bell M M, Joseph S
Scottsdale Memorial Hospital, AZ.
J Am Board Fam Pract. 1990 Oct-Dec;3(4):259-63.
Cholesterol screening was performed on 1140 fifth-grade students in Scottsdale, AZ, as part of a school-affiliated, health-education program. The goals were to determine whether family history of heart disease or high cholesterol can predict which children have high cholesterol levels and to examine the feasibility of screening large numbers of elementary school students. Among the children studied, the mean cholesterol level was 168.3 mg/dL (4.35 mmol/L), and 13 percent had cholesterol levels above 200 mg/dL (5.20 mmol/L). Fifty-four percent had a family member with high cholesterol or a heart attack before age 60 years, but 36 percent of the students with cholesterol levels greater than 200 mg/dL (5.20 mmol/L) had a negative family history. Family history was neither sensitive nor specific as a predictor of elevated cholesterol levels (sensitivity 0.64, specificity 0.47, and positive predictive value 0.16 for predicting cholesterol levels greater than 200 mg/dL [5.20 mmol/L]). Large numbers of children were screened safely and efficiently with good student and parental cooperation. Results of this study do not support the current recommendations to screen children for hypercholesterolemia based upon their family histories.
作为一项与学校相关的健康教育项目的一部分，对亚利桑那州斯科茨代尔市的1140名五年级学生进行了胆固醇筛查。目的是确定心脏病家族史或高胆固醇家族史能否预测哪些儿童胆固醇水平高，并检验筛查大量小学生的可行性。在研究的儿童中，平均胆固醇水平为168.3毫克/分升（4.35毫摩尔/升），13%的儿童胆固醇水平高于200毫克/分升（5.20毫摩尔/升）。54%的儿童有家庭成员在60岁之前患有高胆固醇或心脏病发作，但胆固醇水平高于200毫克/分升（5.20毫摩尔/升）的学生中，36%的家族史为阴性。家族史作为胆固醇水平升高的预测指标既不敏感也不特异（预测胆固醇水平高于200毫克/分升[5.20毫摩尔/升]的敏感性为0.64，特异性为0.47，阳性预测值为0.16）。在学生和家长的良好配合下，大量儿童被安全、高效地进行了筛查。本研究结果不支持目前基于家族史对儿童进行高胆固醇血症筛查的建议。
