TOPLINE:
Only 11.3% of US youths aged 9-21 years are screened for lipid levels, with nearly one in three showing abnormal results. The prevalence of screening increases with age and body mass index (BMI), but fewer than one in five youths with obesity are screened.
METHODOLOGY:
- Researchers conducted a cross-sectional analysis of data from the IQVIA Ambulatory Electronic Medical Record database, including more than 3.2 million US youths aged 9-21 years (53.4% girls) from 2018 to 2021.
- Participants had at least one valid BMI measurement.
- Results of lipid screening tests were categorized as healthy or elevated (borderline or abnormal) on the basis of 2018 cholesterol guidelines.
- Lipid measurements were defined as abnormal if one or more of the following parameters were identified: Levels of total cholesterol ≥ 200 mg/dL, low-density lipoprotein cholesterol (LDL-C) ≥ 130 mg/dL, very LDL-C ≥ 31 mg/dL, non–high-density lipoprotein cholesterol ≥ 145 mg/dL, and triglycerides ≥ 100 mg/dL for children aged 9 years or ≥ 130 mg/dL for those aged 10-21 years.
TAKEAWAY:
- Overall, only 11.3% of youths underwent documented lipid screening, with the frequency of screening increasing with age and BMI (highest in those with severe obesity).
- Of those who were screened, 30.2% had abnormal lipid levels, with the highest prevalence among those aged 9-11 years (32.3%).
- Compared with youths with healthy weight, the prevalence of abnormal lipid results was higher among those with overweight (adjusted prevalence ratio [aPR], 1.58; 95% CI, 1.56-1.61), moderate obesity (aPR, 2.16; 95% CI, 2.14-2.19), and severe obesity (aPR, 2.53; 95% CI, 2.50-2.57).
- Abnormal results were the most frequent for triglycerides (25.5% of the screened population), followed by total cholesterol (11.4%) and LDL-C (9.5%).
IN PRACTICE:
"Our study adds observational evidence that a large proportion of youths who receive screening have elevated lipid levels and might benefit from early intervention," the authors wrote. "This is a missed opportunity for referring children and families to guideline-recommended treatment, which includes lifestyle modification and the use of lipid-lowering medication."
SOURCE:
The study was led by Angela M. Thompson-Paul, PhD, MSPH, of the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention in Atlanta. It was published online on July 23, 2024, in JAMA Network Open, along with an invited commentary.
LIMITATIONS:
The data were not nationally representative and only characterized healthcare-seeking individuals. Laboratory test results were included only if the facility conducting the test contributed data to IQVIA, potentially leading to the underestimation of screening in patients. Incomplete information regarding the fasting state of patients may have affected the results.
DISCLOSURES:
The study did not mention any funding information. One author reported conducting this analysis as part of a Public Health Informatics Institute contract with the Centers for Disease Control and Prevention and another work through Kraushold Consulting during the same period.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.