Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany.
DZHK (German Centre for Cardiovascular Research), Berlin, Germany.
BMC Public Health. 2019 Dec 3;19(1):1627. doi: 10.1186/s12889-019-7901-z.
Recommendations on preventive lipid screening among children and adolescents remain controversial. The aim of the study was to assess age and puberty-related changes in serum lipids, including total cholesterol (TC), and high-density (HDL-C) and non-high-density lipoprotein cholesterol (Non-HDL-C).
Using cross-sectional data from the National Health Interview and Examination Survey for Children and Adolescents in Germany (KiGGS 2003-2006; N = 13,676; 1-17 years), changes in distributions of serum lipids were visualized according to sex, age and maturation. Youth aged 10-17 years were classified as prepubescent, early/mid-puberty, and mature/advanced puberty. Multiple linear regressions were used to quantify the impact of pubertal stage on serum lipid levels, adjusted for potential confounding factors.
Among children 1-9 years mean serum lipid measures increased with age, with higher mean TC and Non-HDL-C among girls than boys. Among children 10-17 years, advanced pubertal stage was independently related to lower lipid measures. Adjusted mean TC, HDL-C and Non-HDL-C was 19.4, 5.9 and 13.6 mg/dL lower among mature/advanced puberty compared to prepubescent boys and 11.0, 4.0 and 7.0 mg/dL lower in mature/advanced puberty compared to prepubescent girls.
Lipid concentrations undergo considerable and sex-specific changes during physical growth and sexual maturation and significantly differ between pubertal stages. Screening recommendations need to consider the fluctuations of serum lipids during growth and sexual maturation.
关于儿童和青少年预防性血脂筛查的建议仍存在争议。本研究旨在评估血清脂质（包括总胆固醇 [TC]、高密度脂蛋白胆固醇 [HDL-C] 和非高密度脂蛋白胆固醇 [Non-HDL-C]）随年龄和青春期变化的情况。
利用德国儿童和青少年国家健康访谈和体检调查（KiGGS 2003-2006 年；N=13676 例；1-17 岁）的横断面数据，根据性别、年龄和成熟度来观察血清脂质分布的变化。10-17 岁的青少年分为青春期前、早期/中期和成熟/晚期。采用多元线性回归来量化青春期阶段对血清脂质水平的影响，同时调整潜在混杂因素。
1-9 岁儿童的平均血清脂质指标随年龄增长而增加，女孩的 TC 和 Non-HDL-C 均值高于男孩。10-17 岁儿童中，晚期青春期阶段与较低的血脂指标独立相关。与青春期前男孩相比，成熟/晚期青春期的 TC、HDL-C 和 Non-HDL-C 平均水平分别低 19.4、5.9 和 13.6mg/dL，与青春期前女孩相比，TC、HDL-C 和 Non-HDL-C 平均水平分别低 11.0、4.0 和 7.0mg/dL。
在身体生长和性成熟过程中，脂质浓度会发生显著变化，且具有性别特异性，青春期各阶段之间存在显著差异。血脂筛查建议需要考虑生长和性成熟过程中血清脂质的波动。
