Major Finding: The prevalence of abnormal lipid levels is estimated to be 14% for normal weight, 22% for overweight, and 43% for obese youths aged 12-19 years.
Data Source: Analysis of National Health and Nutrition Examination Survey data for 1999-2006.
Disclosures: The authors are employees of the CDC.
Abnormal lipid levels are present in 20% of U.S. youths aged 12-19 years, according to estimates reported by investigators at the Centers for Disease Control and Prevention.
An analysis of data derived from four cycles of the National Health and Nutrition Examination Survey during 1999-2006 found that the prevalence of abnormal lipid levels increased with rising body mass index (BMI), from 14% of normal weight to 22% of overweight and 43% of obese adolescents.
“Based on the findings in this study, clinicians should be aware of lipid screening guidelines and recommended interventions for children and youths who are overweight or obese,” the authors wrote (MMWR 2010;59:29-33).
Abnormal blood lipid levels were defined using the same cutoffs recommended by the American Academy of Pediatrics for targeted screening of children aged 2 years or older: an LDL cholesterol level of 130 mg/dL or greater, an HDL cholesterol level of 35 mg/dL or lower, and a triglyceride level of 150 mg/dL or greater.
The survey data covered a cross-sectional sample of 3,125 youths who had fasting blood samples taken for lipid testing. A total of 32% of the sample—15% of overweight and 17% of obese participants—would be candidates for screening for abnormal blood lipid levels based on the AAP recommendations for BMI screening.
A greater percentage of boys had low HDL cholesterol levels (11%), compared with girls (4%). Older participants aged 18-19 years had higher rates of low HDL cholesterol (10%) and high triglyceride levels (16%) than did participants aged 12-13 years (5% and 10%, respectively). Non-Hispanic white youths were more likely than non-Hispanic black youths to have low HDL cholesterol (9% vs. 5%) or high triglyceride levels (12% vs. 4%).
Although the AAP recommends considering pharmacologic treatment of children whose LDL cholesterol remains persistently high even after lifestyle counseling, less than 1% of the adolescents in this NHANES study and a previous analysis of the same NHANES data set were found to have “lipid levels high enough to warrant drug therapy according to AAP guidelines,” the CDC investigators reported.