Dyslipidemia in Adolescents Seen in a University Hospital in the city of Rio de Janeiro/Brazil: Prevalence and Association

Abstract

BackgroundEarly exposure to obesity favors greater risks of cardiovascular factors such as dyslipidemia.ObjectivesTo establish the prevalence of dyslipidemia, and to evaluate its association with nutritional status of the adolescents attended at the ambulatory of the Adolescent Health Studies Center of the University Hospital Pedro Ernesto.MethodsThis is a cross-sectional, observational study, the sample of which was of convenience, consisting of adolescents from 12 to 18 years old of both genders. The lipid profile was evaluated, along with its association with the anthropometric indicators: body mass index and waist circumference. For statistical analysis, a significance level of 5% was used.ResultsA total of 239 adolescents, 104 boys (43.5%) and 135 girls (56.5%) were evaluated and, of these, 52 (21.8%) were eutrophic, 60 (25.1%) overweight, and 127 (53.1%) obese. Obeseadolescents had significantly lower mean values of HDL-cholesterol (44.7 mg/dl vs 53.9 mg/dl; p < 0.001) and higher triglycerides (109.6 mg/dl vs 87.3 mg/dl; p = 0.01). The changes with higher prevalence were low HDL-cholesterol (50.6%), hypercholesterolemia (35.1%), and hypertriglyceridemia (18.4%). A negative association of HDL-cholesterol with body mass index and a positive association of triglycerides with body mass index could be observed, even after adjustment for gender and skin color.ConclusionThis study demonstrated high prevalence of dyslipidemia among adolescents. In view of the significant association between lower levels of HDL-cholesterol and increased triglycerides with overweight, the control of these factors should receive attention, with the precocious diagnosis of the dyslipidemia being important, mainly if it is associated with another cardiovascular risk, to develop effective intervention strategies.

The Importance of Identifying Risk Factors in Childhood and Adolescence

“…It may be due to a weak relationship between LDL-c levels and obesity since obesity interferes minimally with LDL-c levels 10 except where obesity-related metabolic changes unmask an underlying genetic dyslipidemia. In the present cross-sectional study 1 obesity seems to be the driver of the lipid changes as prevalence of low HDL-c and association of abdominal adiposity with triglycerides levels, without changes in LDL-c values. 1 Despite these findings, high LDL-c is a well-established risk factor for atherosclerosis as observed in familial hypercholesterolemia, and early detection allows the initiation of pharmacological therapy even in the children.…”

“…In the present cross-sectional study 1 obesity seems to be the driver of the lipid changes as prevalence of low HDL-c and association of abdominal adiposity with triglycerides levels, without changes in LDL-c values. 1 Despite these findings, high LDL-c is a well-established risk factor for atherosclerosis as observed in familial hypercholesterolemia, and early detection allows the initiation of pharmacological therapy even in the children. 11…”

“…The obese group had a predominance of low HDL-c besides the positive association of body mass index (BMI) and abdominal circumference with triglyceride values. 1 These date are fundamental and warn of the importance of early assessment of risk factors.…”

“…The present study reinforces that current obesity is a growing epidemic. 1 The Universal screening would allow for earlier diagnosis and intervention for children with dyslipidemia secondary to lifestyle or genetic factors. 12…”

Índices de Castelli I e II como preditores robustos na estimativa do risco cardiovascular de adolescentes com excesso de peso

“…A alta prevalência de DLP em adolescentes, principalmente no Norte e Nordeste do Brasil, também foi descrita no Estudo de Riscos Cardiovasculares em Adolescentes (ERICA) (Faria Neto et al, 2016), caracterizado principalmente por hipertrigliceridemia e baixa concentração de HDL-c. Vizentin et al (2019) encontraram, além da alta prevalência de DLP, associação significativa entre elevada concentração de TG, baixo conteúdo de HDL-c e sobrepeso em adolescentes. Em nosso estudo, a hipertrigliceridemia entre os adolescentes obesos foi 30% superior à observada entre os indivíduos do grupo magreza/eutrofia, enquanto que o conteúdo de colesterol associado à HDL foi 14% inferior.…”