Temporal trends in lipid testing among children and adolescents: A population based study

Abstract

Unfavorable lipid levels during childhood are associated with subsequent development of atherosclerotic cardiovascular disease. The American Academy of Pediatrics and National Heart, Lung and Blood Institute in 2011 recommended universal lipid screening for children between ages 9–11 years and between ages 17–21 years. The objective of the study was to determine temporal trends in lipid testing among children and young adults in a mid-western population. The Rochester Epidemiology Project database was used to identify lipid testing in ages 2–21 years (n = 51,176) in the Olmsted County population from January 1, 2008 through December 31, 2014. Generalized estimating equations with Poisson distribution were used to test for temporal trends in lipid testing across the age groups. There was modest increase in lipid testing in children in the age groups, 9–11 years and 17–21 years (1.5% in 2008 to 2.2% in 2014, P < 0.001 and 4.4% in 2008 to 4.6% in 2014, P = 0.02, respectively). There was a significant decrease in proportion of 17–21 year olds with elevated total cholesterol (16.2% in 2008 to 11.6% in 2014; P = 0.01) and non-high density lipoprotein cholesterol (22.6% in 2008 to 12.6% in 2014; P < 0.001). In this population-based study, rates of lipid testing increased minimally only in the last six years. Further longitudinal studies are warranted to improve guideline dissemination and address attitudes, practices and barriers to lipid testing in children and young adults.

Evaluating the prevalence of lipid assessments in children in Alberta, Canada

“…11 In the United States, although some studies have shown lipid screening rates of around 20%, 16,17 other analyses have identi fied lower rates (2%-7%) in otherwise healthy children. [18][19][20][21] Although we were unable to determine the reason for lipid assessment in the present study, it is reasonable to assume that a substantial proportion of assessments were performed as part of a selective screening approach related to the presence of other cardiovascular risk factors or the diagnosis of pre mature cardiovascular disease in family members. 14 Support ing this, the frequency of initial lipid assessment increased gradually with age, from 0.1% among 2yearold children to 4.8% among 17yearold adolescents, suggesting that assess ments may have been performed owing to the presence of other risk factors that accumulated with time.…”

“…Previous work has similarly shown that limited access to care impedes routine health assessments, including pediatric lipid assess ments. 17,21 Strategies are thus needed to improve rates of lipid screening in vulnerable communities with reduced access to primary care. 22 We leveraged an overlap of ages between the 2 cohorts (9 and 10yearold children) to evaluate changes in lipid assess ment practices between the cohort periods (2012-2014 for those from the older cohort v. 2019-2021 for those from the younger cohort).…”

Pediatric Obesity: Complications and Current Day Management

“…Despite the high frequency of dyslipidemia in children and universal screening guidelines, screening rates are still very low [41][42][43]. Therefore, the true prevalence of dyslipidemia is likely underestimated.…”

Update on management of paediatric dyslipidaemia

“…Despite the availability of well tolerated and efficacious treatment options, children with hypercholesterolemia are frequently underdiagnosed, untreated or undertreated. Although NHLBI guidelines recommend universal screening, there guidelines are not being universally implemented [114][115][116][117]. Efforts to increase awareness among generalists and to remove barriers to such care will be essential for implementation.…”