New approach for detection of LDL-hypercholesterolemia in the pediatric population: The Fr1dolin-Trial in Lower Saxony, Germany

Kordonouri, Olga; Lange, Karin; Boettcher, Isa; Christoph, J; Marquardt, Erika; Tombois, Claire; Galuschka, Laura; Stiller, Doris; Mueller, Iris; Roloff, F.; Aschemeier, B; Danne, Thomas

doi:10.1016/j.atherosclerosis.2018.11.011

Cited by 20 publications

(23 citation statements)

References 16 publications

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“…It assesses: (1) whether the early diagnosis of type 1 diabetes in the context of regular medical check‐ups in childhood is feasible and efficient; (2) whether ketoacidosis and the hospitalization of children can be prevented by screening; and (3) whether psychological distress can be reduced with the early diagnosis of diabetes, education and care. Similar studies have already commenced in Lower Saxony, Germany, with additional screening for low‐density lipoprotein–hypercholesterolemia (Fr1dolin Study) and in Colorado, with additional screening for celiac disease (ASK Study) .…”

Section: Practical Perspectivesmentioning

confidence: 94%

Birth and coming of age of islet autoantibodies

Bonifacio

Achenbach

2019

Clinical and Experimental Immunology

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Section: Practical Perspectivesmentioning

confidence: 94%

Birth and coming of age of islet autoantibodies

Bonifacio

Achenbach

2019

Clinical and Experimental Immunology

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“…Notably, children with familial hypercholesterinemia would benefit from early diagnosis [11]. However, no universal lipid screening has been implemented in Germany as of October 2019 [10, 12] .…”

Section: Introductionmentioning

confidence: 99%

Age, maturation and serum lipid parameters: findings from the German Health Survey for Children and Adolescents

et al. 2019

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BackgroundRecommendations on preventive lipid screening among children and adolescents remain controversial. The aim of the study was to assess age and puberty-related changes in serum lipids, including total cholesterol (TC), and high-density (HDL-C) and non-high-density lipoprotein cholesterol (Non-HDL-C).MethodsUsing cross-sectional data from the National Health Interview and Examination Survey for Children and Adolescents in Germany (KiGGS 2003–2006; N = 13,676; 1–17 years), changes in distributions of serum lipids were visualized according to sex, age and maturation. Youth aged 10–17 years were classified as prepubescent, early/mid-puberty, and mature/advanced puberty. Multiple linear regressions were used to quantify the impact of pubertal stage on serum lipid levels, adjusted for potential confounding factors.ResultsAmong children 1–9 years mean serum lipid measures increased with age, with higher mean TC and Non-HDL-C among girls than boys. Among children 10–17 years, advanced pubertal stage was independently related to lower lipid measures. Adjusted mean TC, HDL-C and Non-HDL-C was 19.4, 5.9 and 13.6 mg/dL lower among mature/advanced puberty compared to prepubescent boys and 11.0, 4.0 and 7.0 mg/dL lower in mature/advanced puberty compared to prepubescent girls.ConclusionsLipid concentrations undergo considerable and sex-specific changes during physical growth and sexual maturation and significantly differ between pubertal stages. Screening recommendations need to consider the fluctuations of serum lipids during growth and sexual maturation.

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“…Screening for islet autoantibodies is performed in people with a genetic predisposition for type 1 diabetes to investigate the natural history of the disease and when enrolling patients into interventional trials aimed at delaying the requirement for insulin replacement therapy [1, 3–9]. More recently, islet autoantibody screening has been piloted in the general population in Germany as part of routine healthcare to identify asymptomatic diabetes, known as stage 1 type 1 diabetes [10], and prevent diabetic ketoacidosis at the population level [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Landmark models to define the age-adjusted risk of developing stage 1 type 1 diabetes across childhood and adolescence

Hoffmann

Weiß

Winkler

et al. 2019

BMC Med

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Background Autoimmune diseases are often preceded by an asymptomatic autoantibody-positive phase. In type 1 diabetes, the detection of autoantibodies to pancreatic islet antigens in genetically at-risk children is prognostic for future clinical diabetes. Testing for islet autoantibodies is, therefore, performed in a range of clinical studies. Accurate risk estimates that consider the a priori genetic risk and other risk modifiers are an important component of screening. The age of an individual is an under-appreciated risk modifier. The aim of this study was to provide age-adjusted risk estimates for the development of autoantibodies across childhood in genetically at-risk children. Methods The prospective BABYDIAB and BABYDIET studies included 2441 children from birth who had a first-degree relative with type 1 diabetes. Children were born between 1989 and 2006 and were regularly followed from birth for the development of islet autoantibodies and diabetes. A landmark analysis was performed to estimate the risk of islet autoantibodies at birth and at the age 3.5, 6.5 and 12.5 years. Exponential decay curves were fitted for the risk by the age of 20 years. Results The risk of islet autoantibodies by the age of 20 years was 8%, 4.6%, 2.6% and 0.9%, at the landmark ages of birth, 3.5, 6.5 and 12.5 years, respectively. The short-term risks (within 6 years of follow-up) at these landmark ages were 5.3%, 2.9%, 1.8% and 1%, respectively. The decline in autoantibody risk with age was modelled using a one-phase exponential decay curve ( r = 0.99) with a risk half-life of 3.7 years. This risk decay model was remarkably consistent when the outcome was defined as islet autoantibody-positive or multiple islet autoantibody-positive and when the study cohort was stratified by HLA risk genotype. A similar decay model was observed for coeliac disease-associated transglutaminase antibodies in the same cohort. Unlike the risk of developing islet autoantibodies, the rate of developing clinical diabetes in children who were islet autoantibody-positive did not decline with age. Conclusion The risk of developing autoantibodies drops exponentially with age in children with a first-degree relative with type 1 diabetes. Electronic supplementary material The online version of this article (10.1186/s12916-019-1360-3) contains supplementary material, which is available to authorized users.

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New approach for detection of LDL-hypercholesterolemia in the pediatric population: The Fr1dolin-Trial in Lower Saxony, Germany

Cited by 20 publications

References 16 publications

Birth and coming of age of islet autoantibodies

Birth and coming of age of islet autoantibodies

Age, maturation and serum lipid parameters: findings from the German Health Survey for Children and Adolescents

Landmark models to define the age-adjusted risk of developing stage 1 type 1 diabetes across childhood and adolescence

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