Relación entre factores genéticos y medioambientales y la hipercolesterolemia en niños / Relationship between genetic and environmental factors and hypercholesterolemia in children

RESUMEN

Introducción. La hipercolesterolemia infantil aumentó en las últimas décadas. Conocer los factores ambientales y genéticos que influyen sobre ella permitiría establecer pautas de pesquisa más adecuadas. Objetivos. Analizar si existe asociación entre factores genéticos y ambientales y la hipercolesterolemia en niños. Evaluar las cualidades predictivas de las variables que muestren asociación con la hipercolesterolemia. Material y métodos. Estudio observacional, analítico, transversal. Población alumnos de todas las escuelas de Jovita. Edad > 6 y < 12 años. Se midió la colesterolemia total. Mediante encuestas a los padres, se evaluó la historia clínica familiar (HCF) y el nivel socioeconómico (NSE). Se registró el peso y la talla para determinar el estado nutricional. Por medio de una encuesta al niño, se identificó el nivel de actividad física y los hábitos dietéticos. Se evaluó la asociación mediante el cálculo de OR (p < 0,05). Se efectuaron pruebas diagnósticas sobre las variables para predecir hipercolesterolemia. Resultados. Se incluyeron382 alumnos. La media de colesterolemia fue de 168 mg/dl. Un 13,4% presentaron hipercolesterolemia. El sedentarismo fue del 22,8%, y la obesidad, del 10,5%. La HCF positiva, el NSE alto-mediano y la obesidad se asociaron con hipercolesterolemia (OR 2,10; 2,10 y 2,05, respectivamente). No se encontró asociación entre actividad física e ingesta de grasas y colesterol e hipercolesterolemia. La HCF positiva y el NSE alto-mediano mostraron sensibilidad (75% y 88%) para predecir hipercolesterolemia. La hipercolesterolemia de ambos padres en relación con la hipercolesterolemia del hijo mostró un OR 9,59, sensibilidad de 73%, especificidad de 71%, valor predictivo positivo de 57% y negativo de 83%. Conclusiones. La HCF positiva, el NSE alto-mediano y la obesidad se asociaron con hipercolesterolemia en el niño. La hipercolesterolemia en ambos padres presentó una asociación con la de los niños y mostró un buen potencial como factor predictor y criterio de pesquisa.

ABSTRACT

Introduction. Pediatric hypercholesterolemia has increased over the past decades. Knowing the environmental and genetic factors that have an impact on it would allow establishing more adequate screening guidelines. Objectives. To determine if there is an association between genetic and environmental factors and hypercholesterolemia in children. To assess the predictive qualities of outcome measures associated with hypercholesterolemia. Material and methods. Observational, analytical, cross-sectional study. Population students from all schools located in Jovita. Age > 6 and < 12 years old. The total cholesterol level was measured. A survey was administered to parents to assess their family medical history (FMH) and socioeconomic level (SEL). Weight and height were recorded to establish nutritional status. A survey was administered to children to identify their level of physical activity and their eating habits. The association was assessed by estimating the OR value (p < 0.05). Diagnostic tests were done to establish outcome measures that predict hypercholesterolemia. Results. Three hundred and eighty-two students were included. Their mean cholesterol level was 168 mg/dL, and 13.4% had hypercholesterolemia. A sedentary lifestyle was observed in 22.8%, and obesity, in 10.5%. A positive FMH, a high/ middle SEL, and obesity were associated with hypercholesterolemia (OR 2.10, 2.10 and 2.05, respectively). No association was found between physical activity and fat/cholesterol intake and hypercholesterolemia. A positive FMH and a high/middle SEL were sensitive enough (75% and 88%) to predict hypercholesterolemia. The presence of hypercholesterolemia inboth parents in relation to hypercholesterolemia in their child showed an OR of 9.59, a sensitivity of 73%, a specificity of 71%, a positive predictive value of 57%, and a negative predictive value of 83%. Conclusions. A positive FMH, a high/ middle SEL, and obesity were associated with hypercholesterolemia in children. The presence of hypercholesterolemia in both parents was associated with hypercholesterolemia in their child and showed itself to be a great potential predictor and screening criterion.