More than 20% of children and adolescents in the United States had at least one abnormal cholesterol level between 2011 and 2014, according to a report from the CDC’s National Center for Health Statistics.
Duong Nguyen, DO, an epidemic intelligence service officer at the CDC, and colleagues provided estimates for the National Health and Nutrition Examination Survey 2011-2014 regarding the prevalence of high total cholesterol (≥ 200 mg/dL), low HDL (< 40 mg/dL) and high non-HDL (≥ 145 mg/dL) in U.S. children and adolescents aged 6 to 19 years.
Prevalence increases with age, BMI
The researchers estimated that 21% of U.S. children and adolescents had high total cholesterol, low HDL or high non-HDL during the years studied, and they wrote that the prevalence increased with age (aged 6-8 years, 14.3%; aged 16-19 years, 26.9%; P for trend < .05).
The data revealed no difference in prevalence between boys (20.9%) and girls (21%), but there was a lower prevalence in non-Hispanic black children and adolescents (17.8%) than in non-Hispanic white (21.5%; P < .05) or Hispanic (22.3%; P < .05) children and adolescents.
The prevalence of an abnormal cholesterol measure was more likely with increased BMI (normal weight, 13.8%; overweight, 22.3%; obese, 43.3%; P for trend < .05), Nguyen and colleagues wrote.
High total cholesterol was prevalent in 7.4% of U.S. children and adolescents; was more prevalent in older adolescents (aged 6-8 years, 6%; aged 16-19 years, 8.9%; P < .05); was more prevalent in girls than in boys (8.9% vs. 5.9%; P < .05); was more prevalent in non-Hispanic Asians (10.9%; P vs. Hispanics and non-Hispanic whites < .05) and non-Hispanic blacks (9.6%; P vs. Hispanics < .05) than in non-Hispanic whites (7.3%) or Hispanics (6.3%); and was more prevalent in those with obesity (11.6%; P < .05) than in those with normal weight (6.3%) or overweight (6.9%), the authors wrote.
Low HDL was estimated to occur in 13.4% of U.S. children and adolescents, increasing with age (aged 6-8 years, 7.7%; aged 16-19 years, 18.4%; P for trend < .05); was more prevalent in boys (14.8%) than girls (12%; P < .05); was more prevalent in non-Hispanic whites (14.4%) and Hispanics (15.6%) vs. non-Hispanic blacks (7.4%; P < .05) and non-Hispanic Asians (8.2%; P < .05); and increased in prevalence with BMI (normal weight, 6.8%; overweight, 14.8%; obese, 33.2%; P for trend < .05), they wrote.
High non-HDL was estimated in 8.4% of the study population, with highest prevalence in those aged 16 to 19 years (12%; P vs. other age groups < .05), girls (9.4% vs. 7.5% for boys; P < .05) and those with higher BMI (normal weight, 5.7%; overweight, 9.7%; obese, 16.7%; P for trend < .05), according to the authors.
Implications for prevention
“Some CVD risk factors, including cholesterol, track from childhood into adulthood,” Nguyen and colleagues wrote. “Continued monitoring of abnormal cholesterol levels among children and adolescents may inform public health interventions to promote long-term [CV] health and prevent CVD in adulthood. – by Erik Swain
The authors are employees of the CDC.