Pediatric decision limits for lipid parameters in the Brazilian population
Journal Title: Jornal de Pediatria - Year 2019, Vol 95, Issue 2
Abstract
Disorders of lipid and lipoprotein metabolism are commonly observed in obese and insulin resistant states, and are often referred to as diabetic dyslipidemia. Diabetic dyslipidemia is characterized by high plasma triglycerides, reduced high-density lipoprotein cholesterol (HDL-C), and increased levels of small dense low-density lipoprotein (LDL) particles, which collectively increase the risk of premature atherosclerosis and cardiovascular disease. These lipid abnormalities result from overproduction of triglyceride-rich hepatic and intestinal lipoproteins, which are rapidly metabolized to generate highly atherogenic remnant lipoprotein particles. While cardiovascular complications are often only observed later in adulthood, the genesis of atherosclerosis begins in childhood and cardiovascular risk factors early in life are associated with increased carotid intima-media thickness (CIMT), a non-invasive measure of subclinical atherosclerosis,1 as well as increased severity of atherosclerosis measured at autopsy.2,3 Furthermore, cardiovascular risk factors such as diabetic dyslipidemia present in childhood often continue into adulthood and increase risk of morbidity and mortality.4,5 For adults, cardiovascular disease assessment guidelines, including decision limits for lipid parameters, have largely been established based on prospective cohort studies.6 However, decision limits for lipid parameters in the pediatric population are often derived from adult decision limits or by calculating a specified lipid level percentile from a healthy reference population, as cardiovascular outcome measures are difficult to establish during the pediatric age.1,7,8
Authors and Affiliations
Khosrow Adeli
Keywords
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- EP ID EP497391
- DOI 10.1016/j.jped.2018.05.002
- Views 77
- Downloads 0
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