Trends in Serum Lipids Among US Youths Aged 6 to 19 Years, 1988-2010

Study Questions:

Have lipids improved among American youth?

Methods:

Data from the National Health and Nutrition Examination Survey (NHANES) during three time periods: 1988-1994 (6,397 youths), 1999-2002 (6,995 youths), and 2007-2010 (4,957 youths) were used for the present analysis. Cross-sectional analysis of serum lipid concentrations among 16,116 children and adolescents, ages 6-19 years, were examined for trends over time. The primary outcomes of interest were mean serum total cholesterol (TC), non–high-density lipoprotein cholesterol (non–HDL-C), and HDL-C. For adolescents (ages 12-19 years) only, low-density lipoprotein cholesterol (LDL-C) and geometric mean triglyceride levels were examined. Trends in adverse lipid concentrations were described for TC levels of 200 mg/dl and greater, non–HDL-C levels of 145 mg/dl and greater, HDL-C levels of <40 mg/dl, LDL-C levels of 130 mg/dl and greater, and triglyceride levels of 130 mg/dl and greater.

Results:

Among youths ages 6-19 years, between 1988-1994 and 2007-2010, there was a decrease in mean TC (from 165 mg/dl [95% CI, 164-167] to 160 mg/dl [95% CI, 158-161]; p < 0.001), and a decrease in the prevalence of elevated TC (from 11.3% [95% CI, 9.8%-12.7%] to 8.1% [95% CI, 6.7%-9.5%]; p = 0.002). Mean HDL-C significantly increased between 1988-1994 and 2007-2010, but the prevalence of low HDL-C did not change. Mean non–HDL-C and prevalence of elevated non–HDL-C both significantly decreased over the study period. In 2007-2010, 22% (95% CI, 20.3%-23.6%) of youths had either a low HDL-C level or high non–HDL-C, which was lower than the 27.2% (95% CI, 24.6%-29.7%) in 1988-1994 (p = 0.001). Among adolescents between 1988-1994 and 2007-2010, there was a decrease in mean LDL-C (from 95 mg/dl [95% CI, 92-98] to 90 mg/dl [95% CI, 88-91]; p = 0.003) and a decrease in geometric mean triglycerides (from 82 mg/dl [95% CI, 78-86] to 73 mg/dl [95% CI, 70-76]; p < 0.001). Prevalence of elevated LDL-C and triglycerides between 1988-1994 and 2007-2010 also significantly decreased.

Conclusions:

The investigators concluded that between 1988-1994 and 2007-2010, a favorable trend in serum lipid concentrations was observed among youths in the United States, but almost 1 in 10 had elevated TC in 2007-2010.

Perspective:

These results are encouraging. Lipid profiles demonstrate a favorable trend over recent years. However, the number of children and adolescents with poor lipid profiles remains too high.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Hypertriglyceridemia, Lipid Metabolism, Nonstatins

Keywords: Prevalence, Cholesterol, Ethnic Groups, Dyslipidemias, Cross-Sectional Studies, Cardiology, Lipids, Cardiovascular Diseases, Lipoproteins, Triglycerides, Nutrition Surveys, United States


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