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Performance of gender- and age-specific cut-points versus NCEP pediatric cutpoints in dyslipidemia screening among Chinese children.

Published on Jan 1, 2019in Atherosclerosis4.255
· DOI :10.1016/J.ATHEROSCLEROSIS.2018.11.018
Pei Xiao2
Estimated H-index: 2
(Peking Union Medical College),
Tao Huang43
Estimated H-index: 43
(PKU: Peking University)
+ 4 AuthorsChina Child2
Estimated H-index: 2
Abstract
Abstract Background and aims Considerable attention is given nowadays to the presence of cardiovascular diseases risk factors in children. The current blood lipid classification system for Chinese children was based on the United States National Cholesterol Education Program (NCEP) cutpoints, which did not take the age, gender and race differences into consideration. This study aimed to develop gender- and age-specific lipid cutpoints for dyslipidemia screening in Chinese children and compare the ability of new cutpoints and NCEP pediatric cutpoints to predict obesity and unfavorable blood pressure (BP) levels. Methods Data were obtained from a nationwide multicenter cross-sectional study: The China Child and Adolescent Cardiovascular Health Study, comprising 12,875 Chinese children aged 6–18 years. We calculated cutpoints for abnormal levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) that were linked to Chinese adult abnormal lipid thresholds using the General Additive Model for Location Scale and Shape method. Results Borderline-high and high cutpoints (TC, LDL-C and TG) as well as low cutpoints (HDL-C) were developed to classify the abnormal blood lipid levels in Chinese children. Better performance for prediction of obesity, elevated BP, and hypertension were found with the proposed cutpoints in comparison with the NCEP pediatric cutpoints (AUC for obesity: 0.612 vs. 0.597, p = 0.017; AUC for elevated BP: 0.529 vs. 0.521, p = 0.017; AUC for hypertension: 0.536 vs. 0.527, p = 0.016). Conclusions The gender- and age-specific cutpoints should improve the accuracy of dyslipidemia screening in China and be more reasonable in practice.
  • References (43)
  • Citations (4)
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References43
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#2Hugh Chul Kim (Yonsei University)H-Index: 16
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Background Several studies have examined tracking pattern of blood lipids level during long follow-up periods in Western countries. However, there have been few such studies in Asian populations.
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#1Tianwei Gu (NU: Nanjing University)H-Index: 3
#1Tianwei Gu (NU: Nanjing University)H-Index: 10
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Background Previous national survey suggested that dyslipidemia is an increasing burden in China and more severe in urban population. In this study, we retrospectively analyzed the gender and age differences in lipids and lipoproteins in a large Chinese urban population in Nanjing city. Methods A total of 236, 945 adults (age ≥20 years old) who undertook a health check between 2009 and 2015 in our medical examination center were involved in the analysis. Fasting total cholesterol, high-density l...
3 CitationsSource
#1Joseph T. Flynn (Seattle Children's)H-Index: 26
#2David C. Kaelber (Case Western Reserve University)H-Index: 17
Last. Elaine M. Urbina (Cincinnati Children's Hospital Medical Center)H-Index: 44
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These pediatric hypertension guidelines are an update to the 2004 “Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents.” Significant changes in these guidelines include (1) the replacement of the term “prehypertension” with the term “elevated blood pressure,” (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplifi...
502 CitationsSource
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#2Ulrik Lausten-Thomsen (UCPH: University of Copenhagen)H-Index: 8
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SummaryContext Accumulating evidence suggests that fat distribution is a better predictor of cardiovascular disease than body mass index (BMI). Objective The aim of this study was to investigate the association of android and gynoid fat percentages with lipid profiles to determine whether android and/or gynoid fat percentages are associated with serum lipid levels. Design A population-based cross-sectional study. Patients Five thousand six hundred and ninety-six adults (20 years and older) who p...
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BACKGROUND: Measurement of cholesterol and triglyceride (TG) fractions in blood has become standard practice in the early detection of atherosclerotic disease pathways. Considerable attention is given nowadays to the presence of these risk factors in children and to start preventive campaigns early in life. In this context, it is imperative to have valid comparative frameworks for interpretation of lipid levels. The aim of this study is to present sex-and age-specific reference values on blood l...
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#1Xiaohua Liang (CQMU: Chongqing Medical University)H-Index: 3
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Objective. The increased blood pressure level in children and adolescents is recognized as an essential predictor of adulthood cardiovascular disease. This study aimed to ascertain the prevalence and the urban-rural disparity of childhood hypertension in the southwest of China. Methods. Using stratified cluster sampling in urban and rural areas, a total of 13597 primary school children aged 6∼12 years living in the Southwest of China were included. The prevalence of hypertension was analyzed. Th...
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#1Haibo LiH-Index: 2
#2Tao Huang (PKU: Peking University)H-Index: 43
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Abstract Objective Vitamin D is involved in various physiologic and pathologic processes in the human body. Aim of our study was to determine the prevalence of vitamin D deficiency and associations of adiposity indicators with 25-hydroxyvitamin D (25[OH]D) in Chinese children and adolescents. Research Methods & Procedures A population-based, nationwide and multicenter cross-sectional study involving 10,696 pediatric participants (51.2% boys) aged 6-18 years. Total body fat mass was assessed by d...
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#1Pei XiaoH-Index: 2
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Objective Vitamin D deficiency has recently evolved as a major public health issue worldwide. But the relationship between vitamin D and cardiovascular health in children remains unclear. Accordingly, we aimed to examine the associations between 25-hydroxyvitamin D (25(OH)D) concentrations and cardiometabolic risk factors, and to assess the possible effect modification of obesity on the associations in a Chinese pediatric population. Research design and methods A cross-sectional sample of 6091 c...
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The prevalence of childhood hypertension is recognized as an important parameter of cardiovascular risk in adults. This retrospective study aimed to ascertain the prevalence and risk factors for hypertension from birth through childhood as of 2014. Stratified cluster sampling was used to select 17,007 participants (5971 with biochemical indexes available) aged 6–12 years on two avenues per region in urban, suburban, and rural areas. The prevalence of hypertension was 12.55%; children with obesit...
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