With the epidemic of childhood obesity in the United States, there is concern that overweight and obese children need to be screened for chronic medical conditions, including high cholesterol levels.
However, body fat is not an effective indicator of high cholesterol in children, according to new University of Michigan research.
Those are the findings of a U-M study led by U-M pediatricians Joyce Lee, M.D., MPH, and Matthew Davis, M.D., MAPP, which will appear in the August 3 edition of the Archives of Pediatric and Adolescent Medicine.
"We found, actually, that using body mass index to find kids with high cholesterol does not work well. There were many overweight and obese kids who had normal cholesterol, and there were a fair number of healthy-weight kids who had high cholesterol," says Lee, a member of the Child Health Evaluation and Research (CHEAR) Unit in the U-M Division of General Pediatrics, and assistant professor in the Department of Pediatrics and Communicable Diseases at the U-M Medical School.
The study was conducted after the American Academy of Pediatrics revised its cholesterol screening guidelines in July 2008, advocating a cholesterol check for kids who have increased risk of heart disease. For the most part, that means all children who are overweight or obese, which is about 30% of kids in the U.S.
"Our results indicate that the AAP guidelines for cholesterol screening in kids may need to be revised," says Lee. "Otherwise, we may be missing high cholesterol in some kids and unnecessarily testing others."
The authors performed the study with national data from thousands of children to see whether 'body mass index' (BMI), a measure of body fat based on height and weight, can be used as a reliable way to find kids with high cholesterol levels. They looked at the relationship between BMI and two different cholesterol measures, including total cholesterol and low density lipoprotein (LDL) cholesterol, i.e. "bad" cholesterol.
For this study, children were classified as overweight if their BMI was between the 85th and 95th percentiles, and defined as obese if their BMI was greater than the 95th percentile for weight based on age and height. Children had abnormal levels if they had a total cholesterol greater than 200 mg/dl or LDL cholesterol level of greater than 130 mg/dl.
This study found that screening all overweight or obese children would identify approximately 50% of children with abnormal cholesterol levels but would also lead to unnecessary testing for up to 30% of children.
Other studies have looked at additional screening strategies for abnormal cholesterol in children on the basis of having a family history of early heart disease or high cholesterol. But as Lee notes, "A positive family history also performs poorly for identifying children with high cholesterol levels. Therefore, it may be more efficient for the AAP to recommend a public health campaign to reduce cholesterol among all children, rather than screening high-risk groups."
In addition to Lee and Davis, co-authors include Achamyeleh Gebremariam, MS, from the University of Michigan, and colleagues from the Arkansas Center for Health Improvement, including Paula Card-Higginson, BA, ELS, Jennifer L. Shaw, DrPH, MPH, MAP, and Joseph W. Thompson, MD, MPH.
This work was funded by the Robert Wood Johnson Foundation. Dr. Lee was also supported by NIDDK K08DK082386 and the Clinical Sciences Scholars Program at the University of Michigan.
Anne Rueter | EurekAlert!
Second cause of hidden hearing loss identified
20.02.2017 | Michigan Medicine - University of Michigan
Prospect for more effective treatment of nerve pain
20.02.2017 | Universität Zürich
In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport
Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...
The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.
The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...
Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...
Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".
Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...
13.02.2017 | Event News
10.02.2017 | Event News
09.02.2017 | Event News
20.02.2017 | Materials Sciences
20.02.2017 | Health and Medicine
20.02.2017 | Health and Medicine