Relationship between genetic and environmental factors and hypercholesterolemia in children

Abstract

Introduction. Pediatric hypercholesterolemia has increased over the past decades. Knowing the environmental and genetic factors that have an impact on it would allow establishing more adequate screening guidelines. Objectives. To determine if there is an association between genetic and environmental factors and hypercholesterolemia in children. To assess the predictive qualities of outcome measures associated with hypercholesterolemia. Material and methods. Observational, analytical, cross-sectional study. Population: students from all schools located in Jovita. Age: ≥ 6 and < 12 years old. The total cholesterol level was measured. A survey was administered to parents to assess their family medical history (FMH) and socioeconomic level (SEL). Weight and height were recorded to establish nutritional status. A survey was administered to children to identify their level of physical activity and their eating habits. The association was assessed by estimating the OR value (p < 0.05). Diagnostic tests were done to establish outcome measures that predict hypercholesterolemia. Results. Three hundred and eighty-two students were included. Their mean cholesterol level was 168 mg/dL, and 13.4% had hypercholesterolemia. A sedentary lifestyle was observed in 22.8%, and obesity, in 10.5%. A positive FMH, a high/ middle SEL, and obesity were associated with hypercholesterolemia (OR: 2.10, 2.10 and 2.05, respectively). No association was found between physical activity and fat/cholesterol intake and hypercholesterolemia. A positive FMH and a high/middle SEL were sensitive enough (75% and 88%) to predict hypercholesterolemia. The presence of hypercholesterolemia in both parents in relation to hypercholesterolemia in their child showed an OR of 9.59, a sensitivity of 73%, a specificity of 71%, a positive predictive value of 57%, and a negative predictive value of 83%. Conclusions. A positive FMH, a high/ middle SEL, and obesity were associated with hypercholesterolemia in children. The presence of hypercholesterolemia in both parents was associated with hypercholesterolemia in their child and showed itself to be a great potential predictor and screening criterion.