Published online July 3, 2006
PEDIATRICS Vol. 118 No. 1 July 2006, pp. 165-172 (doi:10.1542/peds.2005-2968)

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (11) Citing Articles via Google Scholar Google Scholar Articles by Friedman, L. A. Articles by Sprecher, D. L. Search for Related Content PubMed PubMed Citation Articles by Friedman, L. A. Articles by Sprecher, D. L. Related Collections Heart & Blood Vessels Social Bookmarking                         What's this?

Sensitivity and Specificity of Pediatric Lipid Determinations for Adult Lipid Status: Findings From the Princeton Lipid Research Clinics Prevalence Program Follow-up Study

Lisa Aronson Friedman, ScM^a, John A. Morrison, PhD^b,c, Stephen R. Daniels, MD, PhD^d, William F. McCarthy, PhD^a and Dennis L. Sprecher, MD^e

^a Maryland Medical Research Institute, Baltimore, Maryland
^b Division of Cardiology, Children’s Hospital Medical Center, Cincinnati, Ohio
^c Department of Pediatrics, University of Cincinnati Medical Center, Cincinatti, Ohio
^d Department of Pediatrics, University of Colorado School of Medicine, Denver, Colorado
^e DM-Experimental Therapeutics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

OBJECTIVE. The goal was to determine the diagnostic utility of the National Cholesterol Education Program pediatric guidelines.

METHODS. With the use of pediatric lipid data from the Cincinnati Clinic of the Lipid Research Clinics Prevalence Study and lipid and cardiovascular disease data collected for the same subjects as adults in the Princeton Follow-up Study, the sensitivity and specificity of the National Cholesterol Education Program pediatric guidelines were calculated overall and according to age. Furthermore, whether use of parental cardiovascular disease history during childhood influenced the sensitivity and specificity was assessed.

RESULTS. Overall sensitivities were 43% to 46% and specificities were 82% to 86% for total and low-density lipoprotein cholesterol levels. There was considerable variation in sensitivities according to age, with the lowest sensitivities at ages 14 to 16 years and the highest sensitivities at ages 5 to 10 years and 17 to 19 years. Results were similar whether or not the population was restricted to children with a positive parental history of cardiovascular disease.

CONCLUSIONS. Results of our analyses suggest that the sensitivity and specificity for evaluating total cholesterol or low-density lipoprotein cholesterol levels that are elevated in adulthood are not improved by selecting children with a positive parental history. These data also show the strong role that age (particularly the pubertal years between 10 and 15 years of age) plays in lipid measurements for children and adolescents. Continued prospective and longitudinal studies designed with age as well as other risk parameters are needed to determine the best guidelines for clinical screening in the future.

---

Key Words: low-density lipoprotein cholesterol • adolescent • child • sensitivity • specificity • lipoproteins

Abbreviations: NCEP—National Cholesterol Education Program • CVD—cardiovascular disease • LDL—low-density lipoprotein • PFS—Princeton Follow-up Study • LRC—Lipid Research Clinics

---

Accepted Feb 8, 2006.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J. M. Lee, A. Gebremariam, P. Card-Higginson, J. L. Shaw, J. W. Thompson, and M. M. Davis Poor Performance of Body Mass Index as a Marker for Hypercholesterolemia in Children and Adolescents Arch Pediatr Adolesc Med, August 1, 2009; 163(8): 716 - 723. [Abstract] [Full Text] [PDF]

				C. Hu, F. Tao, Y. Wan, J. Hao, and D. Ye Normal Reference Values for Serum Lipid Levels in Chinese Adolescents Between 12 and 18 Years of Age J Trop Pediatr, June 8, 2009; (2009) fmp042v1. [Abstract] [Full Text] [PDF]

				P. O. Kwiterovich Jr. Recognition and Management of Dyslipidemia in Children and Adolescents J. Clin. Endocrinol. Metab., November 1, 2008; 93(11): 4200 - 4209. [Abstract] [Full Text] [PDF]

				D. Kamerow Should we screen for and treat childhood dyslipidaemia? BMJ, July 23, 2008; 337(jul23_2): a886 - a886. [Full Text]

				S. R. Daniels, F. R. Greer, and and the Committee on Nutrition Lipid Screening and Cardiovascular Health in Childhood Pediatrics, July 1, 2008; 122(1): 198 - 208. [Abstract] [Full Text] [PDF]

				J. A. Morrison, L. A. Friedman, and C. Gray-McGuire Metabolic Syndrome in Childhood Predicts Adult Cardiovascular Disease 25 Years Later: The Princeton Lipid Research Clinics Follow-up Study Pediatrics, August 1, 2007; 120(2): 340 - 345. [Abstract] [Full Text] [PDF]

				L. L. Hayman, J. C. Meininger, S. R. Daniels, B. W. McCrindle, L. Helden, J. Ross, B. A. Dennison, J. Steinberger, and C. L. Williams Primary Prevention of Cardiovascular Disease in Nursing Practice: Focus on Children and Youth: A Scientific Statement From the American Heart Association Committee on Atherosclerosis, Hypertension, and Obesity in Youth of the Council on Cardiovascular Disease in the Young, Council on Cardiovascular Nursing, Council on Epidemiology and Prevention, and Council on Nutrition, Physical Activity, and Metabolism Circulation, July 17, 2007; 116(3): 344 - 357. [Full Text] [PDF]

				S. S. Gidding New Cholesterol Guidelines for Children? Circulation, September 5, 2006; 114(10): 989 - 991. [Full Text] [PDF]