Screening and Treatment for Lipid Disorders in Children and Adolescents: Systematic Evidence Review for the US Preventive Services Task Force

Haney, Elizabeth M; Huffman, Laurie Hoyt; Bougatsos, Christina; Freeman, Michele; Steiner, Robert D.; Nelson, Heidi D

doi:10.1542/peds.2006-1801

Cited by 177 publications

(150 citation statements)

References 242 publications

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“…Given that 40 to 55% of children and adolescents with high levels of TC and LDLc will track these high levels up to 15 years later 38 , the possibility that these dyslipidemic young individuals will become adults at high risk of cardiovascular disease justifies early intervention strategies.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors and metabolic syndrome in a population of young students from the National University of Colombia

Feliciano-Alfonso¹,

Mendivil²,

Ariza³

et al. 2010

Rev. Assoc. Med. Bras.

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SummaryObjective. To estimate prevalence and distribution of cardiovascular risk factors and Metabolic Syndrome (MS) in young individuals admitted to the National University of Colombia in Bogotá.MethOds. An analytic cross-sectional study was conducted in a sample of 249 individuals of both genders aged 15 to 20 years. A questionnaire was personally administered to collect demographic, socioeconomic, smoking, perinatal, and women's health data. Anthropometric measurements, blood pressure, and a fasting blood sample were taken. Prevalence of MS was determined and compared using criteria from several qualified institutions. Results. We found a high prevalence of smoking (18.9%), arterial prehypertension (14.1%) and overweight (11.2%), 9.2% of study participants had prediabetes, and the most frequent dyslipidemia was low HDL cholesterol (13.3%). Alcoholic beverage consumption was declared by 60.6% of study participants. Body mass index was associated with significant increases in blood pressure, LDL cholesterol and plasma triglyceride levels. Gestational age at birth was inversely associated with presence of low HDL cholesterol levels and high blood pressure. Prevalence of the MS varied markedly according to the definition employed: 9.2% using REGODCI (Research Group on Diabetes and Chronic Illnesses) criteria, 2% using IDF (International Diabetes Federation) criteria, and 2.4% using AHA (American Heart Association) criteria. cOnclusiOn. The encountered prevalence of modifiable cardiovascular risk factors justifies promotion of therapeutic lifestyle changes among this age group in Colombia. Further harmonization of MS criteria in young individuals is needed. caRdiOvasculaR Risk factORs and MetabOlic syndROMe in a pOpulatiOn Of yOung students fROM the natiOnal univeRsity Of cOlOMbia jOhn edwin felicianO-alfOnsO 1* , caRlOs OliMpO Mendivil 2 , iván daRíO sieRRa aRiza 3 , claRa eugenia péRez 4 Study conducted at

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Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors and metabolic syndrome in a population of young students from the National University of Colombia

Feliciano-Alfonso¹,

Mendivil²,

Ariza³

et al. 2010

Rev. Assoc. Med. Bras.

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“…Definitive diagnosis of FH should be made before the age of 10 to consider intervention, anticipating an effect of diet therapy on psychosomatic growth and the development of arteriosclerotic lesions. Ideally, FH screening should be conducted by measuring the serum lipid level once around 10 years of age in all children 33,34) . Average Japanese children undergo a hematology and blood biochemistry check-up at least a few times before they reach 10 years old of age on various occasions, including health checks and consultations for diseases.…”

Section: Fh In Screening Of Childrenmentioning

confidence: 99%

Guidelines for the Management of Familial Hypercholesterolemia

Harada‐Shiba

Arai

Oikawa

et al. 2012

JAT

167

164

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Familial hypercholesterolemia (FH) is a highly prevalent autosomal dominant hereditary disease, generally characterized by three major signs, hyper-low-density-lipoprotein (LDL) cholesterolemia, tendon/skin xanthomas and premature coronary artery disease (CAD). Because the risk of CAD is very high in these patients, they should be identified at an early stage of their lives and started on intensive treatment to control LDL-cholesterol. We here introduce a new guideline for the management of FH patients in Japan intending to achieve better control to prevent CAD. Diagnostic criteria for heterozygous FH are 2 or more of 1) LDL-cholesterol ≥ 180 mg/dL, 2) tendon/skin xanthoma(s), and 3) family history of FH or premature CAD within second degree relatives, for adults; and to have both 1) LDL-cholesterol ≥ 140 mg/dL and 2) family history of FH or premature CAD within second degree relatives, for children. For the treatment of adult heterozygous FH, intensive lipid control with statins and other drugs is necessary. Other risks of CAD, such as smoking, diabetes mellitus, hypertension etc., should also be controlled strictly. Atherosclerosis in coronary, carotid, or peripheral arteries, the aorta and aortic valve should be screened periodically. FH in children, pregnant women, and women who wish to bear a child should be referred to specialists. For homozygotes and severe heterozygotes resistant to drug therapies, LDL apheresis should be performed. The treatment cost of homozygous FH is authorized to be covered under the program of Research on Measures against Intractable Diseases by the Japanese Ministry of Health, Labour, and Welfare.

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“…It is derived from the seed husk of Plantago ovata (11) and is considered a useful supplement to dietary therapy (National Cholesterol Education Program (NCEP) Step 1 and 2 diets) for the treatment of hypercholesterolaemic patients. Despite this, Haney et al (12) and Spence et al (13) have expressed certain doubts with regard to the dose -response relationship and long-term efficacy of the treatment.Although these positive effects have been clearly demonstrated in hypercholesterolaemic adults (7) , there are few, mostly old, published studies on the use of psyllium or other fibre mixtures in children or adolescents (9,10) and some (13,14) have reported inconclusive results.We hypothesised that psyllium supplementation exerts an additional lipid-lowering effect on serum LDL-C concentrations in dyslipidaemic paediatric subjects treated with the NCEP Step 2 diet. * Corresponding author: Professor S. A. Ribas, fax þ55 21 2587 6494, email ribasnut@yahoo.com.br…”

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confidence: 99%

Effects of psyllium on LDL-cholesterol concentrations in Brazilian children and adolescents: a randomised, placebo-controlled, parallel clinical trial

et al. 2014

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The present study investigated the LDL-cholesterol (LDL-C)-lowering effects of psyllium in Brazilian dyslipidaemic children and adolescents. A total of fifty-one individuals (6 -19 years) with mild-to-moderate hypercholesterolaemia were evaluated by conducting a randomised, double-blind, placebo-controlled, parallel clinical trial. Over an 8-week trial period, the participants were randomly allocated to one of two groups (control: n 25 and psyllium: n 26) using a computer-generated random number sequence. Fasting blood samples, dietary records and anthropometric data were collected. Both groups were treated with the National Cholesterol Education Program Step 2 diet for 6 weeks before randomisation. After this run-in period, a daily supplement of 7·0 g psyllium was given to the intervention group, while an equivalent amount of cellulose was given to the control group. Statistically significant changes between the control and intervention groups over time were observed for total cholesterol (7·7 %; 20·39 mmol/l; P ¼ 0·003) and LDL-C (10·7 %; 20·36 mmol/l; P ¼ 0·01). None of the participants reported any aversion to the smell, taste, appearance or texture of psyllium. No serious adverse effects were reported during the study. In addition to causing a significant reduction in LDL-C concentrations, psyllium therapy was found to be both safe and acceptable for the treatment of hypercholesterolaemic children and adolescents.Key words: Dyslipidaemia: Psyllium: Children: Adolescents Atherosclerotic CVD is a leading cause of morbidity and premature mortality in Western countries and hypercholesterolaemia is recognised as a major cardiovascular risk factor (1) . Available data indicate that 28 -40 % of Brazilian children and adolescents are dyslipidaemic (2,3) .According to current Brazilian and American guidelines (4,5) , the best way to reduce LDL-cholesterol (LDL-C) concentrations is to follow a low-fat diet supplemented with water-soluble fibres and plant stanols and sterols, combined with weight control and exercise (6) . Alternative dietary therapies have been proposed and efforts have been made to enhance the efficacy of conventional dietary therapy (low-fat diet) to reduce serum cholesterol concentrations through the inclusion of specific foods or food components with known cholesterol-lowering properties (4,6) .A recent systematic review (7) has demonstrated the cholesterol-lowering capacity of the soluble dietary fibre extracted from psyllium husk in adults. Psyllium has been found to lead to reductions ranging from 2·78 to 2 22·8 % in the serum LDL-C concentrations of children and adolescents (8 -10) . The wide range of effects observed in these studies may be related to the quality of the dietary intervention or to the different methods of randomisation, blinding, dietary intake assessment and laboratory measurement.Psyllium is one of the richest known sources of soluble mucilaginous dietary fibre. It is derived from the seed husk of Plantago ovata (11) and is considered a useful supplement to dietary...

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Screening and Treatment for Lipid Disorders in Children and Adolescents: Systematic Evidence Review for the US Preventive Services Task Force

Cited by 177 publications

References 242 publications

Cardiovascular risk factors and metabolic syndrome in a population of young students from the National University of Colombia

Cardiovascular risk factors and metabolic syndrome in a population of young students from the National University of Colombia

Guidelines for the Management of Familial Hypercholesterolemia

Effects of psyllium on LDL-cholesterol concentrations in Brazilian children and adolescents: a randomised, placebo-controlled, parallel clinical trial

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