Cholesterol curves to identify population norms by age and sex in healthy weight children.
OBJECTIVE: Develop clinically applicable charts of lipid values illustrating fluctuations throughout childhood and by sex among healthy weight children. METHODS: The National Health and Nutrition Examination Survey (1999-2008) was used to estimate total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides by age and sex in healthy weight children age 3 to 17 years. Using LMS procedures, the authors created smoothed curves demonstrating population-based 50th percentile for age and the 75th and 95th percentiles. RESULTS: The curves were based on 7681 children meeting inclusion criteria. Total cholesterol, HDL, and LDL demonstrated peaks at approximately 8 to 12 years for boys. Similar peaks were evident for girls at slightly younger ages, approximately 7 to 11 years. Triglycerides showed peaks for girls, but values were similar across ages for boys. CONCLUSIONS: The use of fixed lipid value cutoffs in established guidelines regardless of age or sex likely mislabels many children as abnormal. The authors' charts may allow for a more nuanced interpretation based on population norms.
Skinner, AC; Steiner, MJ; Chung, AE; Perrin, EM
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