Georges Nicolas, Simon Akiki, Naim Bassil, Georges Nawfal, Georges Abi Fares, Tanios Akiki
Holy Spirit University of Kaslik, Faculty of Medicine and Medical Sciences, Pediatric Department, Division of Endocrinology Centre Hospitalier Universitaire Notre Dame des Secours, Byblos, Jbeil, Lebanon.
Int J Pediatr Adolesc Med. 2019 Sep;6(3):101-108. doi: 10.1016/j.ijpam.2019.05.003. Epub 2019 May 31.
Dyslipidemia has been recognized as a risk factor for cardiovascular diseases. Studies have showed that the development of atherosclerotic lesions begins in childhood and progresses throughout life. While the prevalence of dyslipidemia in adults has been reported to be 10 times higher in Lebanon compared to Western countries, data on the prevalence of dyslipidemic children in Lebanon is lacking.
This study was conducted to assess the benefit of a protocol for universal screening for lipid disorders in Lebanese children aged between two and ten years old.
A total of four hundred children aged 2-10 years old (51.5% boys) were included in the study. The subjects were recruited from private pediatric clinics after parental consent. Fasting total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) levels were measured and non-HDL cholesterol was calculated. The values were categorized according to 2011 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents.
The overall prevalence of high TC (≥200 mg/dL), high non-HDL-C (≥145 mg/dL), high LDL (≥130 mg/dL), high TG (≥100 mg/dL) and low HDL (<40 mg/dL) was respectively 19.5%, 23%, 19%, 31.8% and 20%. The overall frequency of dyslipidemia was 51.7%. In a bivariate analysis, dyslipidemia in children was associated with a BMI ≥95th percentile and parents having TC > 240 mg/dL with a P value respectively of .006 and .0001. Furthermore, high TG was independently associated with a BMI ≥95th percentile ( = .0001). Children with parents having TC > 240 mg/dL was significantly correlated with high TC, high non-HDL-C and high LDL ( = .0001 for all variables). Finally, according to the Pediatric Dyslipidemia Screening Guidelines from the 2011 Expert Panel, 62.3% of dyslipidemic children had at least 1 risk factor that qualified them for screening while 37.7% of them didn't have any risk factor.
It is preferable to review the latest pediatric dyslipidemia screening guidelines by performing a universal screening program since a third of our dyslipidemic Lebanese children will be missed.
血脂异常已被公认为心血管疾病的一个危险因素。研究表明，动脉粥样硬化病变始于儿童期，并在一生中不断发展。虽然据报道黎巴嫩成年人血脂异常的患病率比西方国家高10倍，但黎巴嫩血脂异常儿童的患病率数据却很缺乏。
本研究旨在评估一项针对2至10岁黎巴嫩儿童进行血脂异常普遍筛查方案的益处。
共有400名2至10岁的儿童（51.5%为男孩）纳入本研究。经家长同意后，从私立儿科诊所招募受试者。测量空腹总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）水平，并计算非HDL胆固醇。根据2011年儿童和青少年心血管健康与风险降低综合指南专家小组的标准对这些值进行分类。
高TC（≥200mg/dL）、高非HDL-C（≥145mg/dL）、高LDL（≥130mg/dL）、高TG（≥100mg/dL）和低HDL（<40mg/dL）的总体患病率分别为19.5%、23%、19%、31.8%和20%。血脂异常的总体发生率为51.7%。在双变量分析中，儿童血脂异常与BMI≥第95百分位数以及父母TC>240mg/dL相关，P值分别为0.006和0.0001。此外，高TG与BMI≥第95百分位数独立相关（P = 0.0001）。父母TC>240mg/dL的儿童与高TC、高非HDL-C和高LDL显著相关（所有变量的P = 0.0001）。最后，根据2011年专家小组的儿童血脂异常筛查指南，62.3%的血脂异常儿童至少有1个符合筛查条件的危险因素，而37.7%的儿童没有任何危险因素。
由于三分之一的黎巴嫩血脂异常儿童将会被漏筛，因此通过开展普遍筛查计划来重新审视最新的儿童血脂异常筛查指南是可取的。
