Robledo Jorge A, Siccardi Leonardo J, Gallindo Liliana M, Bangdiwala Shrikant I
Programa Interinstitucional de Prevención y Educación en Salud (PIPES), Jovita, Córdoba, Argentina.
Universidad Nacional de Tucumán, Tucumán, Argentina.
Arch Argent Pediatr. 2019 Feb 1;117(1):41-47. doi: 10.5546/aap.2019.eng.41.
Parental hypercholesterolemia would be a better predictor of hypercholesterolemia than family medical history in children.
To compare the strength of association and predictive values of parental hypercholesterolemia versus a positive family history in pediatric hypercholesterolemia. Material and methods. Cross-sectional, analytical study. Cholesterol levels were measured in children aged ≥ 6 and < 12 years and in their biological parents. A survey was administered to parents. The association was estimated using the odds ratio (OR), and its predictive value was determined. The relationship between hypercholesterolemia in parents and their children was studied with multilevel regression.
A total of 332 children, 304 mothers, and 206 fathers were assessed. A cholesterol level ≥ 240 mg/dL in one or both parents and ≥ 200 mg/dL in children showed: OR= 6.40; 95 % confidence interval (CI)= 2.85-14.48; p < 0.0001; sensitivity= 69 %; specihcity= 74 %; positive predictive value (PPV)= 34 %; negative predictive value (NPV)= 93 %; positive likelihood ratio (LR+)= 2.69; negative likelihood ratio (LR-)= 0.42. Family medical history versus children with cholesterol level ≥ 200 showed: OR= 1.86; 95 % CI= 0.84-4.11; p= 0.1272; sensitivity= 69 %; specihcity= 46 %; PPV= 19 %; NPV= 89 %; LR+= 1.27; LR-= 0.68. Cholesterol was 2.9 and 2.5 mg/dL higher per every 10 mg/dL of increased cholesterol in mothers and fathers, respectively.
Parental hypercholesterolemia was significantly associated with hypercholesterolemia in children and showed a higher predictive power than a positive family medical history.
对于儿童高胆固醇血症，父母高胆固醇血症比家族病史是更好的预测指标。
比较父母高胆固醇血症与阳性家族史在儿童高胆固醇血症中的关联强度和预测价值。材料与方法。横断面分析研究。对年龄≥6岁且<12岁的儿童及其亲生父母测量胆固醇水平。对父母进行问卷调查。使用比值比（OR）估计关联，并确定其预测价值。采用多水平回归研究父母高胆固醇血症与其子女之间的关系。
共评估了332名儿童、304名母亲和206名父亲。父母一方或双方胆固醇水平≥240mg/dL且儿童胆固醇水平≥200mg/dL时显示：OR = 6.40；95%置信区间（CI）= 2.85 - 14.48；p < 0.0001；敏感度 = 69%；特异度 = 74%；阳性预测值（PPV）= 34%；阴性预测值（NPV）= 93%；阳性似然比（LR+）= 2.69；阴性似然比（LR-）= 0.42。家族病史与胆固醇水平≥200mg/dL的儿童相比显示：OR = 1.86；95% CI = 0.84 - 4.11；p = 0.1272；敏感度 = 69%；特异度 = 46%；PPV = 19%；NPV = 89%；LR+ = 1.27；LR- = 0.68。母亲和父亲的胆固醇每升高10mg/dL，子女的胆固醇分别升高2.9mg/dL和2.5mg/dL。
父母高胆固醇血症与儿童高胆固醇血症显著相关，且比阳性家族病史具有更高的预测能力。
