[Report on cholesterol levels of Spanish children and adolescents. Group of Experts of Spanish Societies of Arteriosclerosis, Cardiology, Pediatrics, Nutrition and Preventive Medicine]

Abstract

The epidemiological association between blood cholesterol levels and the development of clinical complications of arteriosclerosis, particularly coronary heart disease, is presently well established. The importance of measuring blood cholesterol levels in children and adolescents is supported by numerous evidences: beginning of arteriosclerosis in infancy, relationship between the extent of fatty streaks as determined by post mortem examination of accidentally dead children and previous blood lipid levels, aggregation in children (as in adults) of elevated blood cholesterol levels with other cardiovascular risk factors, tracking of high cholesterol levels (and of other risk factors) from childhood to adolescence and early adulthood, and association of risk factors in children with a parental history of cardiovascular disease. The few epidemiological studies of blood cholesterol in children published in Spain have demonstrated relatively high mean values of blood cholesterol at all ages, which are similar or even higher than those obtained by the LRC Program in the United States during the 1970's. The present report constitutes a metaanalysis of data provided by the authors of 21 Spanish studies, both published and unpublished, carried out during the 1980's on the blood lipid levels of children and adolescents (0-18 years-old) including a total of 19,630 subjects (10,834 males, 8,102 females, and 694 newborns). All data were obtained in cross-sectional studies of normal populations employing different biochemical and statistical methods, thus limiting the value of the conclusions on the true values of blood cholesterol in Spanish children and its changes during recent years. Weighted means were calculated for the means of the different studies taking into account the number of cases in each population, and the distribution in percentiles by age and sex of total cholesterol, triglycerides, LDLc, and HDLc were estimated. For the overall study population, the mean blood cholesterol level and the moderate risk percentile (75) and high risk percentile (95) for both sexes were 173 mg/dl (4.5 mmol/l), 200 mg/dl (5.2 mmol/l), and 225 mg/dl (5.8 mmol/l), respectively. Such levels are between 10 and 15 mg/dl (0.3 and 0.4 mmol/l) higher than those of the LRC Program, and a clear rise was observed from the early to the late 1980's. The present levels of blood cholesterol in children and adolescents have a great potential impact for Public Health policy in Spain. As it occurs in adults, the distributions of blood cholesterol levels in children of different populations reflect their coronary heart disease mortality rates.(ABSTRACT TRUNCATED AT 400 WORDS)