Xiao P, Cheng H, Hou D Q, Gao A Y, Wang L G, Yu Z C, Wang H J, Zhao X Y, Li H B, Huang G M, Mi J
Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; Graduate School of Peking Union Medical College, Beijing 100730, China.
Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Jan 10;41(1):62-67. doi: 10.3760/cma.j.issn.0254-6450.2020.01.012.
To compare the power of dyslipidemia diagnosis by different sets of cut points in the prediction of cardiovascular metabolic risk factors and identify the appropriate cut points for the diagnosis of dyslipidemia in children and adolescents in China. Data were obtained from the baseline survey of 'School-based Cardiovascular and Bone Health Promotion Program' in Beijing in 2017. Dyslipidemia was diagnosed by using two set of cut points. Receiver operating characteristic curve analysis was conducted to assess the power of dyslipidemia diagnosis by the two set of cut points to predict the prevalence of hypertension, obesity, high fat mass percentage and impaired fasting glucose. A total of 14 390 children and adolescents were in included in the study. The prevalence rates of high TC, high LDL-C, low HDL-C, and high TG in the participants were 2.7, 2.7, 14.4, and 3.7 according to 'Chinese Reference Standard', and 5.0, 3.7, 13.3, and 3.5 according to 'China Expert Consensus'. Low HDL-C and high TG defined by the 'Chinese Reference Standard' had better performance for the prediction of high fat mass percentage and obesity in boys, but worse performance in girls (<0.001). Using 'China Reference Standard' can increase the true positive rate in the prediction of obesity or high fat mass percentage in boys, and reduce the false positive rate in girls. The cut points for the diagnosis of dyslipidemia in Chinese children and adolescents need to be further validated by using national representative sample and in longitudinal study.
比较不同切点组对血脂异常的诊断效能，以预测心血管代谢危险因素，并确定适合中国儿童和青少年血脂异常诊断的切点。数据来自2017年北京“学校心血管和骨骼健康促进项目”的基线调查。采用两组切点诊断血脂异常。进行受试者工作特征曲线分析，以评估两组切点对血脂异常的诊断效能，预测高血压、肥胖、高脂肪质量百分比和空腹血糖受损的患病率。共有14390名儿童和青少年纳入研究。根据“中国参考标准”，参与者中高总胆固醇（TC）、高低密度脂蛋白胆固醇（LDL-C）、低高密度脂蛋白胆固醇（HDL-C）和高甘油三酯（TG）的患病率分别为2.7%、2.7%、14.4%和3.7%；根据“中国专家共识”，分别为5.0%、3.7%、13.3%和3.5%。“中国参考标准”定义的低HDL-C和高TG对男孩高脂肪质量百分比和肥胖的预测表现较好，但对女孩的表现较差（<0.001）。使用“中国参考标准”可提高男孩肥胖或高脂肪质量百分比预测的真阳性率，并降低女孩的假阳性率。中国儿童和青少年血脂异常诊断的切点需要通过全国代表性样本和纵向研究进一步验证。
