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在美国社区诊所接受治疗的儿科患者中,按出生状态进行胆固醇筛查。

Cholesterol screening by nativity status in pediatric patients receiving care in United States community-based clinics.

作者信息

Lucas Jennifer A, Marino Miguel, Bailey Steffani R, Kaufmann Jorge, Heintzman John

机构信息

Oregon Health & Science University Department of Family Medicine, 3181 SW Sam Jackson Park Rd., Portland, OR 97239-3098, USA.

Oregon Health & Science University Department of Family Medicine, 3181 SW Sam Jackson Park Rd., Portland, OR 97239-3098, USA; OCHIN, Inc., 1881 SW Naito Pkwy, Portland, OR 97201, USA.

出版信息

Prev Med. 2025 Mar;192:108239. doi: 10.1016/j.ypmed.2025.108239. Epub 2025 Jan 30.

Abstract

OBJECTIVE

Accumulation of cardiovascular risks begins early in life. Some experts recommend cholesterol screening for children aged nine to 11. Latinos living in the U.S. have a high burden of cardiovascular disease and risk factors, and this is further influenced by birthplace, yet information on early screening for cardiovascular disease in this group is sparse.

METHODS

We used electronic health records from a national network including 771 community-based clinics across 21 states from 2012 to 2020, from 310,297 foreign-born Latino, US-born Latino, Latino with unknown birthplace, and non-Hispanic white patients aged nine to 17 years. Logistic regression including demographic and clinical covariates was conducted to estimate prevalence of cholesterol testing, stratified by obesity.

RESULTS

Latino children, regardless of nativity status, had higher adjusted prevalence of cholesterol screening compared to non-Hispanic white children for those with and without obesity. The highest prevalence of screening among those with obesity was in foreign-born Latinos (34.8 %), and among those who were not obese, US-born Latinos had the highest screening prevalence (16.8 %).

CONCLUSIONS

Cholesterol screening was low overall in these community-based clinic patients but differed by ethnicity and nativity status. There is opportunity for further research on outcomes in Latino children to inform guidelines for early screening for cardiovascular health.

摘要

目的

心血管疾病风险的积累在生命早期就已开始。一些专家建议对9至11岁的儿童进行胆固醇筛查。生活在美国的拉丁裔人群心血管疾病负担和风险因素较高,且这会受到出生地的进一步影响,然而关于该群体心血管疾病早期筛查的信息却很稀少。

方法

我们使用了来自一个全国性网络的电子健康记录,该网络包括2012年至2020年期间21个州的771家社区诊所中310297名9至17岁的外国出生的拉丁裔、美国出生的拉丁裔、出生地不明的拉丁裔以及非西班牙裔白人患者的记录。进行了包括人口统计学和临床协变量的逻辑回归分析,以估计按肥胖分层的胆固醇检测患病率。

结果

无论出生情况如何,肥胖和非肥胖的拉丁裔儿童经调整后的胆固醇筛查患病率均高于非西班牙裔白人儿童。肥胖儿童中筛查患病率最高的是外国出生的拉丁裔(34.8%),非肥胖儿童中筛查患病率最高的是美国出生的拉丁裔(16.8%)。

结论

在这些社区诊所患者中,胆固醇筛查总体水平较低,但因种族和出生情况而异。有必要对拉丁裔儿童的筛查结果进行进一步研究,为心血管健康早期筛查指南提供依据。

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