Tomeleri Crisieli M, Ronque Enio R V, Silva Danilo R P, Cardoso Júnior Crivaldo G, Fernandes Rômulo A, Teixeira Denilson C, Barbosa Décio S, Venturini Danielle, Okino Alessandra M, Oliveira Jair A, Cyrino Edilson S
Study and Research Group in Metabolism, Nutrition, and Exercise GEPEMENE, State University of Londrina - UEL, Londrina, Brazil.
Study and Research Group in Metabolism, Nutrition, and Exercise GEPEMENE, State University of Londrina - UEL, Londrina, Brazil.
Rev Port Cardiol. 2015 Feb;34(2):103-9. doi: 10.1016/j.repc.2014.08.020. Epub 2015 Feb 3.
The indiscriminate use of different diagnostic criteria for the definition of dyslipidemia may result in inaccurate interpretations, which could compromise diagnosis and therefore the therapeutic and prophylactic actions to be taken.
To analyze possible differences in prevalence rates of dyslipidemia in adolescents based on three diagnostic definitions.
A cross-sectional study was conducted of a representative sample of Brazilian adolescents between 11 and 16 years of age. Blood samples were collected from 1000 students (423 boys and 577 girls) to determine fasting total cholesterol (TC), HDL and LDL cholesterol, and triglycerides (TG). The prevalence of dyslipidemia was established according to three definitions: those of the National Cholesterol Education Program (NCEP), the Brazilian Society of Cardiology (BSC), and the National Health and Nutrition Examination Survey (NHANES).
Significant differences (p<0.01) were found between the diagnostic criteria for TC (BSC 38.3%; NCEP 11.2%; NHANES 4.8%), HDL cholesterol (BSC 30.0%; NCEP 15.8% NHANES 18.4%), LDL cholesterol (BSC and NCEP 10.8% and NHANES 5.9%), and TG (BSC and NCEP 4.7% and NHANES 1.3%). The overall prevalence of dyslipidemia was 61% (BSC), 28.6% (NCEP) and 24.2% (NHANES). Agreement rates varied significantly (kappa 0.15-0.90).
Although a high prevalence of dyslipidemia was observed in this study regardless of the diagnostic criteria used, the wide variation in rates highlights the need to establish a single definition with appropriate discriminatory power for adolescents.
对血脂异常定义不加区分地使用不同诊断标准可能导致解释不准确，这可能会影响诊断，进而影响应采取的治疗和预防措施。
基于三种诊断定义分析青少年血脂异常患病率的可能差异。
对11至16岁巴西青少年的代表性样本进行横断面研究。采集了1000名学生（423名男孩和577名女孩）的血样，以测定空腹总胆固醇（TC）、高密度脂蛋白和低密度脂蛋白胆固醇以及甘油三酯（TG）。根据三种定义确定血脂异常的患病率：美国国家胆固醇教育计划（NCEP）、巴西心脏病学会（BSC）和美国国家健康与营养检查调查（NHANES）的定义。
在TC（BSC为38.3%；NCEP为11.2%；NHANES为4.8%）、高密度脂蛋白胆固醇（BSC为30.0%；NCEP为15.8%；NHANES为18.4%）、低密度脂蛋白胆固醇（BSC和NCEP为10.8%，NHANES为5.9%）和TG（BSC和NCEP为4.7%，NHANES为1.3%）的诊断标准之间发现了显著差异（p<0.01）。血脂异常的总体患病率分别为61%（BSC）、28.6%（NCEP）和24.2%（NHANES）。一致率差异显著（kappa值为0.15 - 0.90）。
尽管本研究中无论使用何种诊断标准都观察到血脂异常的高患病率，但患病率的广泛差异凸显了为青少年建立具有适当区分能力的单一定义的必要性。
