Cardiometabolic risk factors in siblings from a statewide screening program

Pyles, Lee A.; Lilly, Christa; Joseph, Amy; Mullett, Charles J.; Neal, William A.

doi:10.1016/j.jacl.2020.09.003

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Lipid screening may lead to additional benefits beyond identifying children with dyslipidemia, including discovery and treatment of secondary comorbid conditions (eg, diabetes, hypothyroidism) and identification and treatment of this condition in other family members via cascade testing. However, there is limited direct evidence about additional benefits of screening beyond the child …”

Section: Discussionmentioning

confidence: 99%

“…However, there is limited direct evidence about additional benefits of screening beyond the child. 70, [109][110][111][112] Other observers have surmised that screening and identification of dyslipidemia in children and adolescents with elevated BMI may make weight management interventions more effective; however, limited existing evidence does not support this hypothesis. 113,114 Behavioral counseling intervention trials in children with multifactorial dyslipidemia with and without elevated BMI are needed in addition to trials of behavioral counseling as an adjunct to pharmacotherapy in children with FH.…”

Section: Single Screening Test Identifies Distinct Conditionsmentioning

confidence: 99%

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Screening for Lipid Disorders in Children and Adolescents

Evans

Coppola

Redmond

et al. 2023

JAMA

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ImportanceLipid screening in childhood and adolescence can lead to early dyslipidemia diagnosis. The long-term benefits of lipid screening and subsequent treatment in this population are uncertain.ObjectiveTo review benefits and harms of screening and treatment of pediatric dyslipidemia due to familial hypercholesterolemia (FH) and multifactorial dyslipidemia.Data SourcesMEDLINE and the Cochrane Central Register of Controlled Trials through May 16, 2022; literature surveillance through March 24, 2023.Study SelectionEnglish-language randomized clinical trials (RCTs) of lipid screening; recent, large US cohort studies reporting diagnostic yield or screen positivity; and RCTs of lipid-lowering interventions.Data Extraction and SynthesisSingle extraction, verified by a second reviewer. Quantitative synthesis using random-effects meta-analysis.Main Outcomes and MeasuresHealth outcomes, diagnostic yield, intermediate outcomes, behavioral outcomes, and harms.ResultsForty-three studies were included (n = 491 516). No RCTs directly addressed screening effectiveness and harms. Three US studies (n = 395 465) reported prevalence of phenotypically defined FH of 0.2% to 0.4% (1:250 to 1:500). Five studies (n = 142 257) reported multifactorial dyslipidemia prevalence; the prevalence of elevated total cholesterol level (≥200 mg/dL) was 7.1% to 9.4% and of any lipid abnormality was 19.2%. Ten RCTs in children and adolescents with FH (n = 1230) demonstrated that statins were associated with an 81- to 82-mg/dL greater mean reduction in levels of total cholesterol and LDL-C compared with placebo at up to 2 years. Nonstatin-drug trials showed statistically significant lowering of lipid levels in FH populations, but few studies were available for any single drug. Observational studies suggest that statin treatment for FH starting in childhood or adolescence reduces long-term cardiovascular disease risk. Two multifactorial dyslipidemia behavioral counseling trials (n = 934) demonstrated 3- to 6-mg/dL greater reductions in total cholesterol levels compared with the control group, but findings did not persist at longest follow-up. Harms reported in the short-term drug trials were similar in the intervention and control groups.Conclusions and RelevanceNo direct evidence on the benefits or harms of pediatric lipid screening was identified. While multifactorial dyslipidemia is common, no evidence was found that treatment is effective for this condition. In contrast, FH is relatively rare; evidence shows that statins reduce lipid levels in children with FH, and observational studies suggest that such treatment has long-term benefit for this condition.

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Section: Discussionmentioning

confidence: 99%

Section: Single Screening Test Identifies Distinct Conditionsmentioning

confidence: 99%

Screening for Lipid Disorders in Children and Adolescents

Evans

Coppola

Redmond

et al. 2023

JAMA

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“…Previous studies have indicated that lipid levels are significantly correlated among sibling pairs. Lee A Pyles estimated that the correlation between siblings in LDL-C is 0.375, HDL-C is 0.34 and TG is 0.22 [ 13 ]. This correlation could be due to sibling pairs having similar genes or sharing the same environment or lifestyle.…”

Section: Introductionmentioning

confidence: 99%

Indirect Genetic Effects of ADIPOQ Variants on Lipid Levels in a Sibling Study of a Rural Chinese Population

Zhou

et al. 2022

Genes

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Variations in lipid levels are the result of combinations of genetic and environmental factors. We aim to investigate the indirect effect between siblings of the three polymorphisms of ADIPOQ on serum lipid levels in rural Chinese populations. A total of 2571 sibling pairs were enrolled as study participants. A generalized estimating equation was used to accommodate a family-based design. We used stratified analysis to detect sex combination differences in the indirect genetic effect. We found a significant association between the number of altered risk alleles of rs182052 and ego lipid levels of TG (β = 0.177, P = 0.003), TC (β = 0.140, P = 0.004) and LDL-C (β = 0.098, P = 0.014). Ego and altered genotypes of rs182052 demonstrated a joint effect on ego lipid levels of TC (β = 0.212, P = 0.019), HDL-C (β = 0.099, P = 0.002) and LDL-C (β = 0.177, P = 0.013) in recessive inheritance mode. In opposite-sex siblings, the altered GG genotype of rs182052 increased the ego lipid levels. Thus, our findings demonstrate that ADIPOQ has an indirect genetic effect on lipid levels in sibling pairs, and there are sex-combination differences in the indirect genetic effect in siblings.

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Universal cholesterol screening of youth—Are pediatric lipidologists smarter than a fifth grader?

Kohn

Wilson

2020

Journal of Clinical Lipidology

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Cardiometabolic risk factors in siblings from a statewide screening program

Cited by 4 publications

References 23 publications

Screening for Lipid Disorders in Children and Adolescents

Screening for Lipid Disorders in Children and Adolescents

Indirect Genetic Effects of ADIPOQ Variants on Lipid Levels in a Sibling Study of a Rural Chinese Population

Universal cholesterol screening of youth—Are pediatric lipidologists smarter than a fifth grader?

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