Endocrinology Department, Faculty of Medicine, Saint Joseph University, Saint-Joseph, Beirut, Lebanon.
Biostatistics Department, Faculty of Medicine, Saint Joseph University, Saint-Joseph, Beirut, Lebanon.
Lipids Health Dis. 2019 Feb 11;18(1):48. doi: 10.1186/s12944-019-0991-x.
Few studies looked at the prevalence of dyslipidemia in pediatric Middle-Eastern countries. In addition, worldwide longitudinal changes of lipid profile is not well documented. The purpose of this study is to look at the longitudinal changes of lipid parameters in Lebanese school-age children.
A total of 97 subjects (41 girls and 56 boys) aged between 11 and 21 years were included in this study. The subjects were selected among 339 school-age children with a previous abnormal lipid profile who were recruited from 10 schools of varying socio-economic levels (SEL). A fasting lipid profile [total cholesterol (TC), triglycerides (TG) and HDL-cholesterol (HDL-C)] was performed. Non-HDL-cholesterol (Non-HDL-C) was calculated. Weight and height were measured under the same conditions, and BMI percentiles were calculated. A multivariate covariance analysis model (MANCOVA) was used with TG, HDL-C and non-HDL-C as dependent variables with additional post-MANCOVA F tests.
The age of the current cohort is 16.5 ± 2.9 years with no significant difference according to gender. The current lipid profile was obtained 3.1 ± 0.7 years following the initial one, with 53.6% of the subjects having it normalized. TC, TG, and non-HDL-C decreased significantly over time in girls, while only TG decreased significantly in boys. No significant changes were observed for HDL-C. Using MANCOVA, a significant time by age interaction was observed (p < 0.0001), while gender, BMI and SEL were found not to be significant. Post-hoc F tests showed that the time by age interaction was driven by TG (p = 0.03) and non-HDL-C (p < 0.001), the larger effect being observed in younger children.
A high proportion of school-age children normalize their abnormal lipid profile with time. Screening for lipid disorders could be postponed until post puberty age.
很少有研究关注中东国家儿科人群中血脂异常的流行情况。此外,全球范围内血脂谱的纵向变化也没有得到很好的记录。本研究旨在观察黎巴嫩学龄儿童血脂参数的纵向变化。
本研究共纳入 97 名年龄在 11 至 21 岁之间的受试者(41 名女孩和 56 名男孩)。这些受试者是从 10 所社会经济水平不同的学校中招募的 339 名血脂异常的学龄儿童中筛选出来的。进行空腹血脂谱检查[总胆固醇(TC)、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)]。计算非高密度脂蛋白胆固醇(Non-HDL-C)。在相同条件下测量体重和身高,并计算 BMI 百分位数。采用多元协方差分析模型(MANCOVA),以 TG、HDL-C 和 Non-HDL-C 为因变量,进行多变量协方差分析。
当前队列的年龄为 16.5±2.9 岁,性别间无显著差异。当前的血脂谱是在最初的血脂谱之后 3.1±0.7 年获得的,其中 53.6%的受试者血脂谱已恢复正常。TC、TG 和 Non-HDL-C 在女孩中随时间显著下降,而仅在男孩中 TG 显著下降。HDL-C 无显著变化。采用 MANCOVA 分析,发现时间与年龄之间存在显著的交互作用(p<0.0001),而性别、BMI 和 SEL 则无显著作用。事后 F 检验显示,时间与年龄的交互作用主要由 TG(p=0.03)和 Non-HDL-C(p<0.001)驱动,在年龄较小的儿童中观察到更大的影响。
随着时间的推移,大多数学龄儿童的异常血脂谱会恢复正常。血脂异常的筛查可以推迟到青春期后进行。