Screening Standard for Hypercholesterolemia and Cardiovascular Risk Factors in Children and Adolescents(Papers for Cerebrating the Thirty Aniversary of the Department of Pediatrics, Tokyo Womenu27s Medical College Daini Hospital)

摘要

In order to screen children and adolescents with hypercholesterolemia and atherogenic cardiovascular risk factors, we examined the serum total cholesterol (TC), HDL-cholesterol and atherogenic index (AI) of children and adolescents (27,857 boys and 27,676 girls) aged from five to eighteen years, between the years of 1989 and 1994. They were divided into three age groups, 5～9 years, 10～14 years and 15～18 years, in accordance with the National Cholesterol Education Program (NCEP) and their cardiovascular risk factors were examined based on their family histories and TC levels. In each group, TC levels remained under 200 mg/dl in 86 to 88 percent of cases for both boys and girls. In the group of girls aged 15～18 years, TC levels were 200 to 220 mg/dl, which was higher than that of the boys in the same age group. The incidence of hypercholesterolemia was highest in the 5～9 year old age group. Children and adolescents with hypercholesterolemia over 240 mg/dl had many cardiovascular risk factors. The TC levels of Japanese children and adolescents in the 90th percentile were equal to those of American children and adolescents in the 95th percentile. The 95th percentile values of Japanese children and adolescents registered 210～220 mg/dl, higher than those of American children and adolescents. However, it is necessary to consider changes in TC levels according to sex and age, and establish standard values for determining the cut-off point of hypercholesterolemia. It is also noteworthy that the acceptable value of the cutt-off point for screening hypercholesterolemia in children and adolescents is 200 mg/dl.