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[单中心2至18岁儿童胆固醇异常的发病率及病因]

[Incidence and cause of abnormal cholesterol in children aged 2-18 years in a single center].

作者信息

Yan H, Pang L, Li X Y, Yang W S, Jiang S J, Liu P, Yan C L

机构信息

Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.

Department of Laboratory, Peking University First Hospital, Beijing 100034, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2022 Apr 18;54(2):217-221. doi: 10.19723/j.issn.1671-167X.2022.02.003.

Abstract

OBJECTIVE

To investigate the abnormality and distribution of plasma cholesterol levels in single-center hospitalized children.

METHODS

The blood lipid levels of children aged 2-18 years who had blood lipid test results in Peking University First Hospital from June 2016 to June 2019 were etrospectively analyzed. Cholesterol oxidase method was used for total cholesterol, and high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were detected by clearance method. The counting data were compared with chi-square test.

RESULTS

The survey had involved 11 829 children (7 087 were boys and 4 742 were girls). 1 822 (15.4%) children were with elevated total cholesterol, 1 371 (11.6%) children with elevated low-density lipoprotein cholesterol, and 2 798 (23.7%) children with high-density lipoprotein cholesterol reduction. The total number of the children with abnormal cholesterol levels was 4 427 (37.4%). Among the 7 835 children who visited hospital due to the disease not commonly inducing dyslipidemia, 731 (9.3%) had elevated TC, 561 (7.2%) had elevated LDL-C, 1 886 (24.1%) had decreased HDL-C, and 2 576 (32.9%) had abnormal cholesterol levels. Among the children with different diseases, the difference in the incidence of abnormal cholesterol was statistically significant. The top three main groups of the children with increased total cholesterol and low-density lipoprotein cholesterol were "dyslipidemia", "urinary tract disease", and "nutritional disease"; The top three main groups of the children with reduced high-density lipoprotein cholesterol were "respiratory diseases", "dyslipidemia", "hematological diseases and malignant tumors". Among the 1 257 blood li-pid test results sent by other departments, 300 cases had abnormal cholesterol levels (23.8%). Among them, there were 70 children with hypercholesterolemia (5.6%), 44 children with increased low-density lipoprotein cholesterol (3.5%), and 224 children with reduced high-density lipoprotein cholesterol (17.8%). There were 365 (4.6%) children with low-density lipoprotein cholesterol ≥140 mg/dL (3.6 mmol/L) who needed to further exclude familiar hypercholesterolemia among the children who visited hospitals due to the disease not commonly inducing dyslipidemia.

CONCLUSION

Children in hospitals have a high incidence of cholesterol abnormalities. Doctors need to pay more attention to the cholesterol diagnosis and management regardless of the discipline, which not only helps to control secondary hypercholesterolemia, but also provides the possibility of detecting familial hypercholesterolemia in time.

摘要

目的

探讨单中心住院儿童血浆胆固醇水平的异常情况及分布。

方法

回顾性分析2016年6月至2019年6月在北京大学第一医院进行血脂检测的2至18岁儿童的血脂水平。采用胆固醇氧化酶法检测总胆固醇,用清除法检测高密度脂蛋白胆固醇和低密度脂蛋白胆固醇。计数资料采用χ²检验。

结果

本次调查共纳入11829名儿童(男7087名,女4742名)。总胆固醇升高的儿童有1822名(15.4%),低密度脂蛋白胆固醇升高的儿童有1371名(11.6%),高密度脂蛋白胆固醇降低的儿童有2798名(23.7%)。胆固醇水平异常的儿童总数为4427名(37.4%)。在7835名因非常见致血脂异常疾病就诊的儿童中,731名(9.3%)总胆固醇升高,561名(7.2%)低密度脂蛋白胆固醇升高,1886名(24.1%)高密度脂蛋白胆固醇降低,2576名(32.9%)胆固醇水平异常。不同疾病的儿童中,胆固醇异常发生率差异有统计学意义。总胆固醇和低密度脂蛋白胆固醇升高的儿童前三大主要疾病组为“血脂异常”“泌尿系统疾病”和“营养性疾病”;高密度脂蛋白胆固醇降低的儿童前三大主要疾病组为“呼吸系统疾病”“血脂异常”“血液系统疾病及恶性肿瘤”。在其他科室送检的1257份血脂检测结果中,300例胆固醇水平异常(23.8%)。其中,高胆固醇血症患儿70例(5.6%),低密度脂蛋白胆固醇升高患儿44例(3.5%),高密度脂蛋白胆固醇降低患儿224例(17.8%)。在因非常见致血脂异常疾病就诊的儿童中,有365名(4.6%)低密度脂蛋白胆固醇≥140mg/dL(3.6mmol/L)的儿童需要进一步排除家族性高胆固醇血症。

结论

住院儿童胆固醇异常发生率较高。医生无论哪个学科都需更加关注胆固醇的诊断和管理,这不仅有助于控制继发性高胆固醇血症,还为及时发现家族性高胆固醇血症提供了可能。

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