March 2010: Volume 36, Number 3
Bad News: Abnormal Lipid Levels in Teenagers
At least 20% of teenagers have abnormal lipid levels, placing them at risk for cardiovascular disease (CVD), according to a new study by CDC researchers (MMWR 2010; 59:29–33). Prior studies had indicated that abnormal cholesterol levels had become a problem among adolescents, but the new data documents the problem on a national level.
The researchers analyzed National Health and Nutrition Examination Survey (NHANES) data from 1999–2006. More than 3,000 youths age 12–19 participated in home interviews, had physical examinations in NHANES mobile examination centers, and provided fasting blood samples for lipid profile testing. The prevalence of abnormal lipid levels varied by body mass index (BMI), with 14.2% of normal weight individuals, 22.3% of overweight, and 42.9% of obese having at least one abnormal value, based on cut-offs of ≥130 mg/dL for high LDL-C, ≤35 mg/dL for low HDL-C, and ≥150 mg/dL for triglycerides. The analysis also indicated that girls have higher HDL-C levels compared with boys after puberty, older adolescents are more likely than younger ones to have abnormal lipid levels, and that fewer non-Hispanic black youths have low HDL-C and high triglyceride levels in comparison with non-Hispanic white youths.
Recommendations vary about screening youths for lipid disorders. In 2007, the U.S. Preventive Services Task Force found insufficient evidence to recommend for or against screening, but in 2008 the American Academy of Pediatrics (AAP) called for targeted screening based on family history and other CVD risk factors. Under the AAP recommendations, 32% of study participants would have met criteria for lipid screening based solely on their weight. Approximately 22% of overweight and 43% of obese participants would have been eligible for counseling on therapeutic lifestyle changes.
Based on the study findings, the researchers suggest that clinicians be aware of lipid screening guidelines and recommended interventions for children and youth who are overweight or obese.
To read the report, go to the January 22nd issue of Morbidity and Mortality Weekly Report . Also available online.