儿童和青少年血脂异常筛查:美国预防服务工作组推荐声明。

Screening for Lipid Disorders in Children and Adolescents: US Preventive Services Task Force Recommendation Statement.

机构信息

University of California, San Francisco.

Group Health Research Institute, Seattle, Washington.

出版信息

JAMA. 2016 Aug 9;316(6):625-33. doi: 10.1001/jama.2016.9852.

Abstract

IMPORTANCE

Elevations in levels of total, low-density lipoprotein, and non-high-density lipoprotein cholesterol; lower levels of high-density lipoprotein cholesterol; and, to a lesser extent, elevated triglyceride levels are associated with risk of cardiovascular disease in adults.

OBJECTIVE

To update the 2007 US Preventive Services Task Force (USPSTF) recommendation on screening for lipid disorders in children, adolescents, and young adults.

EVIDENCE REVIEW

The USPSTF reviewed the evidence on screening for lipid disorders in children and adolescents 20 years or younger--1 review focused on screening for heterozygous familial hypercholesterolemia, and 1 review focused on screening for multifactorial dyslipidemia.

FINDINGS

Evidence on the quantitative difference in diagnostic yield between universal and selective screening approaches, the effectiveness and harms of long-term treatment and the harms of screening, and the association between changes in intermediate outcomes and improvements in adult cardiovascular health outcomes are limited. Therefore, the USPSTF concludes that the balance of benefits and harms cannot be determined.

CONCLUSIONS AND RECOMMENDATION

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents 20 years or younger. (I statement).

摘要

重要性

总胆固醇、低密度脂蛋白胆固醇和非高密度脂蛋白胆固醇水平升高;高密度脂蛋白胆固醇水平降低;以及在较小程度上,甘油三酯水平升高,与成年人的心血管疾病风险相关。

目的

更新 2007 年美国预防服务工作组(USPSTF)关于儿童、青少年和年轻人脂质紊乱筛查的建议。

证据回顾

USPSTF 回顾了 20 岁或以下儿童和青少年脂质紊乱筛查的证据 - 1 项研究集中在杂合子家族性高胆固醇血症的筛查,1 项研究集中在多因素血脂异常的筛查。

发现

关于普遍筛查和选择性筛查方法在诊断效果上的定量差异、长期治疗的有效性和危害以及筛查与成人心血管健康结果改善之间的中间结果变化的证据有限。因此,USPSTF 得出结论,无法确定利弊的平衡。

结论和建议

USPSTF 得出结论,目前的证据不足以评估在 20 岁或以下儿童和青少年中筛查脂质紊乱的利弊平衡。(I 级声明)。

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