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Review
. 2015 Dec;20(12):1191-9.
doi: 10.4103/1735-1995.172989.

A systematic review and meta-analysis on screening lipid disorders in the pediatric age group

Roya Kelishadi  1 , Ali Akbar Haghdoost  2 , Mahmood Moosazadeh  3 , Mojtaba Keikha  1 , Maryam Aliramezany  4
Affiliations
Review

A systematic review and meta-analysis on screening lipid disorders in the pediatric age group

Roya Kelishadi et al. J Res Med Sci. 2015 Dec.

Abstract

Background: Different viewpoints exist about lipid screening in all children or only in children with positive family history (FH) of premature cardiovascular diseases (CVDs) or hypercholesterolemia. This systematic review and meta-analysis aim to assess the effectiveness of lipid screening in children and adolescents according to the existence of positive FH of CVD risk factors.

Materials and methods: PubMed, Scopus, and Google scholar were searched to identify relevant papers that were published from November 1980 until 30 November 2013. Irrelevant studies were set aside after studying their title, abstract, and full text. Then, the relevant studies were assessed by using a quality appraisal checklist. We used random effect model for meta-analysis and calculating the total estimation of sensitivity, specificity, and the positive predictive value (PPV) of FH in predicting dyslipidemia among children and adolescents.

Results: Overall, 17,214 studies were identified in the primary search, out of which 19 primary studies were qualified for study entry. The sensitivity of positive FH of premature CVD or dyslipidemia for predicting dyslipidemia among children varied between 15 and 93. Moreover, the effectiveness of screening children for dyslipidemia according to premature CVD or dyslipidemia in their relatives was low in 86.9% of the primary studies. The total estimation of sensitivity, specificity, and predictive value was 42.6, 59, and 20.7, respectively, according to the meta-analysis results.

Conclusion: The present meta-analysis indicated that selecting target population for screening children and adolescents for dyslipidemia according to their FH has low sensitivity.

Keywords: Children; family history (FH); lipid; meta-analysis; screening.

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Figures

Figure 1
Figure 1
Checklist for assessment of the articles’ quality
Figure 2
Figure 2
Literature search and review flowchart for selection of primary studies
Figure 3
Figure 3
The adjusted sensitivity percentage of predicting dyslipidemia in children in each study and overall by the family history of CVD or dyslipidemia. This chart shows that the minimum and maximum of adjusted sensitivity percent among primary studies is 15.1% and 92.5%, respectively; pooled estimate: 42.6 (35.7-49.6), I2 = 99.5%
Figure 4
Figure 4
The adjusted specificity percentage of prediction of dyslipidemia in children in each study and overall by the family history of CVD or dyslipidemia. This chart shows that the minimum and maximum of adjusted specificity percent among primary studies is 13.2% and 80.7%, respectively; pooled estimate: 59 (50.9-67.1), I2 = 99.6%
Figure 5
Figure 5
The adjusted PPV percentage of prediction of dyslipidemia in children in each study and overall by the family history of CVD or dyslipidemia. This chart shows that the minimum and maximum of adjusted sensitivity percent among primary studies is 7.4% and 51.4%, respectively; pooled estimate: 20.7 (12.3-29.1), I2 = 99.7%
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