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. 2012 Aug 8;308(6):591-600.
doi: 10.1001/jama.2012.9136.

Trends in serum lipids among US youths aged 6 to 19 years, 1988-2010

Brian K Kit  1 , Margaret D Carroll, David A Lacher, Paul D Sorlie, Janet M DeJesus, Cyntjl Ogden
Affiliations

Trends in serum lipids among US youths aged 6 to 19 years, 1988-2010

Brian K Kit et al. JAMA. .

Abstract

Context: For more than 20 years, primary prevention of coronary heart disease has included strategies intended to improve overall serum lipid concentrations among youths.

Objective: To examine trends in lipid concentrations among youths from 1988-1994 through 2007-2010.

Design, setting, and participants: Cross-sectional analysis of serum lipid concentrations among 16,116 youths aged 6 to 19 years who participated in the nationally representative National Health and Nutrition Examination Survey during 3 time periods: 1988-1994, 1999-2002, and 2007-2010.

Main outcome measures: Among all youths, mean serum total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C); and among adolescents only, low-density lipoprotein cholesterol (LDL-C) and geometric mean triglyceride levels. Trends in adverse lipid concentrations are reported for TC levels of 200 mg/dL and greater, non-HDL-C levels of 145 mg/dL and greater, HDL-C levels of less than 40 mg/dL, LDL-C levels of 130 mg/dL and greater, and triglyceride levels of 130 mg/dL and greater.

Results: Among youths aged 6 to 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 < .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 = .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 = .001). Among adolescents (aged 12-19 years) 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 = .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 < .001). Prevalence of elevated LDL-C and triglycerides between 1988-1994 and 2007-2010 also significantly decreased.

Conclusions: 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.

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Conflict of interest statement

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Figures

Figure.
Figure.
Prevalence of Adverse Lipid Concentrations Over Time Among US Children and Adolescents, 1988–2010 Adverse lipid concentrations: total cholesterol (TC, ≥200 mg/dL), high-density lipoprotein (HDL) cholesterol (<40 mg/dL), non-HDL cholesterol (≥145 mg/dL), low-density lipoprotein (LDL) cholesterol (≥130 mg/dL), and triglycerides (≥130 mg/dL). All comparisons, except HDL, show a significant linear trend between 1988–1994 and 2007–2010 (P<.05). Comparisons for TC, HDL, non-HDL, and either HDL or non-HDL are among youths aged 6 to 19 years; LDL and triglyceride comparisons are among youths aged 12 to 19 years. Sample sizes: for TC, HDL, non-HDL, and either HDL or non-HDL, 5759 in 1988–1994, 6152 in 1999–2002, and 4205 in 2007–2010; for LDL, 1093 in 1988–1994, 1853 in 1999–2002, and 995 in 2007–2010; and for triglycerides, 1106 in 1988–1994, 1861 in 1999–2002, and 996 in 2007–2010. Error bars indicate 95% CIs. Data are from National Health and Nutrition Examination Surveys.,,
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