Longitudinal study on pediatric dyslipidemia in population‐based claims database

Abstract

The rate of lipid testing among children was low. The ICD-9-CM diagnostic codes showed low sensitivity against laboratory definitions. Though only a small proportion of dyslipidemic children were diagnosed or treated with a medication, co-morbidities associated with dyslipidemia were common.

Prevalence of pediatric dyslipidemia: comparison of a population‐based claims database to national surveys

“…The IHCIS cohort included 16% fasting and 39% non‐fasting children, as well as children with unknown fasting status (45%). Detailed characteristics of these dyslipidemic children were presented in another longitudinal study 10. Table 1 lists the numbers of children in the IHCIS cohort who had a single dyslipidemia or multiple dyslipidemias (only lists the combinations with >1% of the IHCIS cohort subject number) at Index Date.…”

“…Patients in the IHCIS are from all regions of the United States, including 36% from the Northeast, 18% Midwest, 31% South, and 13% West. IHCIS data have been used in many published studies to examine a variety of health issues 10, 12–20. It is one of the few claims databases that contain laboratory measurements.…”

“…Previous studies using the National Health and Nutrition Examination Survey (NHANES) found that approximately 10% of children in the United States had total cholesterol (TC) levels >200 mg/dl,7–9 26% had TG ≥100 mg/dl,9 6.6% had low‐density lipoprotein cholesterol (LDL‐C) ≥130 mg/dl,8 and 19% had high‐density lipoprotein cholesterol (HDL‐C) ≤40 mg/dl 9. Despite the large proportion of children with dyslipidemia, only 7% of children with laboratory eligibility in a large national insurance claims database were tested for lipid levels 10. Among the dyslipidemic children identified in the claims database ( n = 23 475), risk factors (diabetes, hypertension, and obesity) were common, the rates of dyslipidemic diagnosis was 15% and pharmacological therapy 0.1% 10.…”

“…Despite the large proportion of children with dyslipidemia, only 7% of children with laboratory eligibility in a large national insurance claims database were tested for lipid levels 10. Among the dyslipidemic children identified in the claims database ( n = 23 475), risk factors (diabetes, hypertension, and obesity) were common, the rates of dyslipidemic diagnosis was 15% and pharmacological therapy 0.1% 10. Another recent study reported the prevalence of medication use for dyslipidemia was 0.2 per 1000 youths among children with prescription drug benefits managed by CVS Caremark 11…”

“…A literature review has shown a scarcity of pediatric dyslipidemia studies, particularly utilizing administrative medical insurance claims databases. Claims databases allow longitudinal studies that characterize pediatric dyslipidemia as it is detected and managed over time, with regard to the frequency of screening, diagnoses, co‐morbidities, and concomitant medications 10. Cross‐sectional surveys, such as NHANES, in contrast, do not serve these purposes.…”