美国 6 至 19 岁青少年血清脂质趋势，1988-2010 年。
Trends in serum lipids among US youths aged 6 to 19 years, 1988-2010.
机构信息
Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
出版信息
JAMA. 2012 Aug 8;308(6):591-600. doi: 10.1001/jama.2012.9136.
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.
背景
20 多年来，预防冠心病的主要策略一直是改善青少年的整体血清脂质浓度。
目的
检查从 1988-1994 年至 2007-2010 年期间青少年血脂浓度的变化趋势。
设计、地点和参与者：对参加全国代表性的国家健康和营养检查调查的 16116 名年龄在 6 至 19 岁的青少年在三个时期的血清脂质浓度进行横断面分析：1988-1994 年、1999-2002 年和 2007-2010 年。
主要结局指标
在所有青少年中，平均血清总胆固醇（TC）、非高密度脂蛋白胆固醇（非-HDL-C）、高密度脂蛋白胆固醇（HDL-C）；仅在青少年中，低密度脂蛋白胆固醇（LDL-C）和几何平均甘油三酯水平。报告了 TC 水平为 200mg/dL 及以上、非-HDL-C 水平为 145mg/dL 及以上、HDL-C 水平低于 40mg/dL、LDL-C 水平为 130mg/dL 及以上、甘油三酯水平为 130mg/dL 及以上的不良血脂浓度的变化趋势。
结果
在 1988-1994 年至 2007-2010 年期间年龄在 6 至 19 岁的青少年中，TC 平均值（从 165mg/dL[95%置信区间，164-167]降至 160mg/dL[95%置信区间，168-161]；P<.001）和 TC 升高的患病率（从 11.3%[95%置信区间，9.8%-12.7%]降至 8.1%[95%置信区间，6.7%-9.5%]；P=.002）下降。1988-1994 年至 2007-2010 年，HDL-C 平均值显著升高，但低 HDL-C 的患病率没有变化。非-HDL-C 平均值和升高的非-HDL-C 的患病率均在研究期间显著下降。2007-2010 年，22%（95%置信区间，20.3%-23.6%）的青少年要么 HDL-C 水平低，要么非-HDL-C 水平高，这低于 1988-1994 年的 27.2%（95%置信区间，24.6%-29.7%）（P=.001）。在 1988-1994 年和 2007-2010 年期间的青少年（12-19 岁）中，LDL-C 平均值（从 95mg/dL[95%置信区间，92-98]降至 90mg/dL[95%置信区间，88-91]；P=.003）和几何平均甘油三酯（从 82mg/dL[95%置信区间，78-86]降至 73mg/dL[95%置信区间，70-76]；P<.001）也显著下降。1988-1994 年和 2007-2010 年之间 LDL-C 和甘油三酯升高的患病率也显著下降。
结论
在 1988-1994 年至 2007-2010 年期间，美国青少年的血清脂质浓度呈有利趋势，但在 2007-2010 年仍有近 10%的青少年 TC 升高。
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