Yıl: 2021 Cilt: 8 Sayı: 2 Sayfa Aralığı: 155 - 160 Metin Dili: İngilizce DOI: 10.4274/jpr.galenos.2020.02693 İndeks Tarihi: 09-06-2022

Outcomes of Dyslipidemia Screening Program in School-aged Children

Öz:
Aim: Screening of dyslipidemia in childhood has been controversial. While some guidelines recommend screening for dyslipidemia in children, others emphasize that there is insufficient evidence for screening for dyslipidemia in those less than 20 years of age. In this study, we aimed to evaluate the outcomes of a lipid screening program and reveal the pros and cons of this program. Materials and Methods: All patients referred to a paediatric metabolism outpatient clinic by family physicians with the suspicion of dyslipidemia in a lipid screening program at schools were investigated. Demographic and physical examination findings, screening lipid profiles and fasting control lipid profiles of the patients were evaluated. The definitive diagnosis with fasting lipid profile and genetic analysis were recorded. Results: Two hundred seventy-four patients suspected with dyslipidemia were enrolled in the study. The mean age of study group was 9.2±3.2 (5-17) years. While 158 (57.7%) patients were admitted with high total cholesterol (TC) and low-density lipoprotein cholesterol, high triglyceride level was detected in 58 (21.2%) patients via a paediatric lipid screening program. A high TC level was revealed in 26 (9.5%) patients. With the control fasting lipid profile, 100 (36.5%) patients had a normal lipid profile. Fifty-nine (21.5%) patients were diagnosed with familial hypercholesterolemia (FH), and hyperchylomicronemia and hypobetalipoproteinemia were revealed in 5 (1.8%) and 4 (1.5%) patients, respectively. Eleven patients diagnosed with FH did not declare hyperlipidemia in parents. In a screening of these patients’ immediate families, 11 parents and 3 siblings were diagnosed with familial hyperlipidemia. Conclusion: This is the first study performed to date that evaluated the outcomes of a lipid screening program on school age children in Turkey. We found that this screening program is effective in diagnosing not only the patients but also asymptomatic parents and siblings. Evaluation and verification of dyslipidemia should be performed under fasting conditions to avoid false positive results.
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  • 1. Ergin A, Muntner P, Sherwin R, He J. Secular trends in cardiovascular disease mortality, incidence, and case fatality rates in adults in the United States. Am J Med 2004; 117:219-27.
  • 2. National Institutes of Health National Heart, Lung, and Blood Institute. Expert panel on integrated pediatric guideline for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011; 128:1-44.
  • 3. Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for lipid disorders in children and Adolescents: US preventive services task force recommendation statement. JAMA 2016; 316:625-33.
  • 4. Committee on Practice, Ambulatory Medicine, Bright Futures Steering Committee. Recommendations for preventive pediatric health care. Pediatrics 2007; 120:1376.
  • 5. Ritchie SK, Murphy EC, Ice C, et al. Universal versus targeted blood cholesterol screening among youth: The CARDIAC project. Pediatrics 2010; 126:260-5.
  • 6. Okul_sağlığının_korunması_ve_gelyytyrlmesy_programı_ uygulama_kılavuzu. Last Accessed Date: 01.07.2020. Available from: https://okulsagligi.meb.gov.tr/meb_ iys_dosyalar/2017_03/24172657_OKUL_SAYLIYININ_ KORUNMASI_VE_GELYYTYRLMESY_PROGRAMI_UYGULAMA_ KILAVUZU_3256836380940747639.pdf.
  • 7. Ogden CL, Flegal KM. Changes in terminology for childhood overweight and obesity. Natl Health Stat Report 2010; 25:1-5.
  • 8. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011; 128:213-56.
  • 9. Welty FK. Hypobetalipoproteinemia and abetalipoproteinemia. Curr Opin Lipidol 2014; 25:161-8.
  • 10. Nordestgaard BG, Langsted A, Mora S, et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cutpoints-a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Clin Chem 2016; 62:930-46.
  • 11. Szternel L, Krintus M, Bergmann K, Derezinski T, Sypniewska G. Non-fasting lipid profile determination in presumably healthy children: Impact on the assessment of lipid abnormalities. PLoS One 2018; 13:e0198433. doi: 10.1371/journal.pone.0198433.
  • 12. Langsted A, Freiberg JJ, Nordestgaard BG. Fasting and nonfasting lipid levels: influence of normal food intake on lipids, lipoproteins, apolipoproteins, and cardiovascular risk prediction. Circulation 2008; 118:2047-56.
  • 13. Langsted A, Nordestgaard BG. Nonfasting lipids, lipoproteins, and apolipoproteins in individuals with and without diabetes: 58434 individuals from the Copenhagen General Population Study. Clin Chem 2011; 57:482-9.
  • 14. Özbek İpteç B, Balik AR, Yüksel S, Yilmaz FM, Yilmaz G. Hemodilution is not the only reason of difference: Comparison of fasting and non-fasting lipoproteins in paired samples. Clin Biochem 2018; 61:28-33.
  • 15. Mozaffarian D, Benjamin EJ, Go AS, et al; American Heart Association Statistics Committee and stroke statistics subcommittee. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation 2015; 131:e29-322. doi: 10.1161/CIR.0000000000000152.
  • 16. Canda E, Yazici H, Er E, et al. Single center experience of biotinidase deficiency: 259 patients and six novel mutations. J Pediatr Endocrinol Metab 2018; 31:917-26.
  • 17. Langslet G, Ose L. Screening methods in the diagnosis and assessment of children and adolescents with familial hypercholesterolemia. Expert Rev Cardiovasc Ther 2013; 11:1061- 6.
  • 18. Georges N, Simon A, Naim B, Georges N, Georges AF, Tanios A. Universal screening program for lipid disorders in 2-10 years old Lebanese children: A new approach. Int J Pediatr Adolesc Med 2019; 6:101-8.
  • 19. Bibiloni Mdel M, Salas R, Novelo HI, Villarreal JZ, Sureda A, Tur JA. Serum lipid levels and dyslipidaemia prevalence among 2-10 year-old Northern Mexican children. PLoS One 2015; 10:e0119877. doi: 10.1371/journal.pone.0119877.
  • 20. De Ferranti S, Jane N. Dyslipidemia in children: definition, screening, and diagnosis. UpToDate; 2020. Last Accessed Date: 01.07.2020. Available from: https://www-uptodatecom. ezproxy.usek.edu.lb/contents/dyslipidemia-inchildren- definition-screening-anddiagnosis?source.searc result&search.dyslipidemia in children&selectedTitle.1~150.
  • 21. Smith AJ, Turner EL, Kinra S. Universal Cholesterol Screening in Childhood: A Systematic Review. Acad Pediatr. 2016; 16:716-25.
  • 22. Kalkan-Ucar S, Dizdarer C, Darcan S, et al. Prevalence of obesity and overweight among children in İzmir, Turkey: effects of nutritional and socio-economic factors. Obes Metab 2009; 5:99-106.
  • 23. Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006; 1:11-25.
  • 24. Çelmeli G, Çürek Y, Arslan Gülten Z, et al. Remarkable increase in the prevalence of overweight and obesity among school age children in Antalya, Turkey, between 2003 and 2015. J Clin Res Pediatr Endocrinol 2019; 11:76-81.
APA Kose E, köse m, Topçu S, MATUR B, Barış B, ozkan B (2021). Outcomes of Dyslipidemia Screening Program in School-aged Children. , 155 - 160. 10.4274/jpr.galenos.2020.02693
Chicago Kose Engin,köse melis,Topçu Sipil,MATUR Büşra,Barış Buket,ozkan Behzat Outcomes of Dyslipidemia Screening Program in School-aged Children. (2021): 155 - 160. 10.4274/jpr.galenos.2020.02693
MLA Kose Engin,köse melis,Topçu Sipil,MATUR Büşra,Barış Buket,ozkan Behzat Outcomes of Dyslipidemia Screening Program in School-aged Children. , 2021, ss.155 - 160. 10.4274/jpr.galenos.2020.02693
AMA Kose E,köse m,Topçu S,MATUR B,Barış B,ozkan B Outcomes of Dyslipidemia Screening Program in School-aged Children. . 2021; 155 - 160. 10.4274/jpr.galenos.2020.02693
Vancouver Kose E,köse m,Topçu S,MATUR B,Barış B,ozkan B Outcomes of Dyslipidemia Screening Program in School-aged Children. . 2021; 155 - 160. 10.4274/jpr.galenos.2020.02693
IEEE Kose E,köse m,Topçu S,MATUR B,Barış B,ozkan B "Outcomes of Dyslipidemia Screening Program in School-aged Children." , ss.155 - 160, 2021. 10.4274/jpr.galenos.2020.02693
ISNAD Kose, Engin vd. "Outcomes of Dyslipidemia Screening Program in School-aged Children". (2021), 155-160. https://doi.org/10.4274/jpr.galenos.2020.02693
APA Kose E, köse m, Topçu S, MATUR B, Barış B, ozkan B (2021). Outcomes of Dyslipidemia Screening Program in School-aged Children. The Journal of Pediatric Research, 8(2), 155 - 160. 10.4274/jpr.galenos.2020.02693
Chicago Kose Engin,köse melis,Topçu Sipil,MATUR Büşra,Barış Buket,ozkan Behzat Outcomes of Dyslipidemia Screening Program in School-aged Children. The Journal of Pediatric Research 8, no.2 (2021): 155 - 160. 10.4274/jpr.galenos.2020.02693
MLA Kose Engin,köse melis,Topçu Sipil,MATUR Büşra,Barış Buket,ozkan Behzat Outcomes of Dyslipidemia Screening Program in School-aged Children. The Journal of Pediatric Research, vol.8, no.2, 2021, ss.155 - 160. 10.4274/jpr.galenos.2020.02693
AMA Kose E,köse m,Topçu S,MATUR B,Barış B,ozkan B Outcomes of Dyslipidemia Screening Program in School-aged Children. The Journal of Pediatric Research. 2021; 8(2): 155 - 160. 10.4274/jpr.galenos.2020.02693
Vancouver Kose E,köse m,Topçu S,MATUR B,Barış B,ozkan B Outcomes of Dyslipidemia Screening Program in School-aged Children. The Journal of Pediatric Research. 2021; 8(2): 155 - 160. 10.4274/jpr.galenos.2020.02693
IEEE Kose E,köse m,Topçu S,MATUR B,Barış B,ozkan B "Outcomes of Dyslipidemia Screening Program in School-aged Children." The Journal of Pediatric Research, 8, ss.155 - 160, 2021. 10.4274/jpr.galenos.2020.02693
ISNAD Kose, Engin vd. "Outcomes of Dyslipidemia Screening Program in School-aged Children". The Journal of Pediatric Research 8/2 (2021), 155-160. https://doi.org/10.4274/jpr.galenos.2020.02693