Plasma cholesterol and triglyceride distributions in 13,665 children and adolescents: the Prevalence Study of the Lipid Research Clinics Program.

The age-, race-, sex-specific distributions for plasma cholesterol (CH) and triglyceride (TG) are described for the 13,655 individuals under 20 years of age who were examined at the first visit (visit I) of the Prevalence Study of the Lipid Research Clinics (LRC) Program. Composite findings are presented from the seven North American LRC's where children were included in the target population. Cholesterol values are higher for blacks than for whites, but triglyceride values are higher for whites than for blacks. In both the CH and TG distributions for the combined races, the mean values for females are generally higher than for males. For cholesterol, consistent age-associated differences occur. On average, the CH values peak in late childhood and decline during adolescence. The decrease in mean values for CH is most marked for white males. The values for TG tend to increase in early adolescence. This report expands the available information about lipid distributions in young populations and describes the extent of the variation in plasma lipids associated with race and sex for each year of age, 0 to 19 years.

Cigarette smoking, alcohol intake, and oral contraceptives: relationships to lipids and lipoproteins in adolescent school-children.

The effects of cigarette smoking, alcohol intake, and oral contraceptives on plasma cholesterol, triglyceride, high density lipoprotein cholesterol (C-HDL), and low density lipoprotein cholesterol (C-LDL) were assessed in 965 12--19-year-old school-children in the Cincinnati Lipid Research Clinic's Princeton school survey. After pair matching for age, sex, race, and total plasma cholesterol, adolescent children who smoked had mean C-HDL 6.1 mg/dl lower, and mean C-LDL 4.1 mg/dl higher, than nonsmokers (p less than 0.01). These findings for C-HDL were replicated by covariance analysis, adjusting for age, race, sex, alcohol intake, and triglyceride levels. Adolescents who drank alcohol had higher C-HDL and triglyceride levels and lower C-LDL than nondrinkers, but the differences were not significant. Adolescent females taking oral contraceptives had higher triglyceride, C-HDL, and C-LDL levels than matched controls, but the differences were not significant. If a portion of smoking's contribution to coronary heart disease risk is mediated through its inverse association with C-HDL, and if smoking habits initiated in adolescence continue into adulthood, this report provides additional physiologic data relevant to programs designed to prevent, reduce, or stop cigarette smoking in the adolescent years.

Lipid and lipoprotein tracking in children.

Prospective studies in adults reveal that CHD risk is continuously related to total and LDL cholesterol levels (positively) and to HDL cholesterol levels (inversely) throughout their entire distribution. Such findings raise the possibility that children who tend to track in the lowest and highest decile for total and LDL cholesterol may mature to become adults respectively at reduced and increased CHD risk. Children who tend to track in the lowest and highest deciles for HDL cholesterol may also mature to become adults respectively at increased and reduced CHD risk. Although the degree of tracking at either extreme of the distribution, and for the group as a whole, appears to have adquate cohesiveness to be useful for prediction of future lipid and lipoprotein levels, individual children at the extremes of the distributions will need to be followed over longer periods of time, to identify the continuity of childhood and adult values, and eventual CHD risk.

Lipids in schoolchildren 6 to 17 years of age: upper normal limits.

As part of a multiclinic U.S. National Heart, Lung, and Blood Institute study of lipid levels of Americans, the University of Cincinnati studied a total school district's population. Out of a total of 8,906 eligible students from all grades, 6 to 17 years of age, 7,337 participated (82%). After fasting for 12 hours or more, plasma cholesterol and triglyceride levels were ascertained in 6,775 children. For white and black boys and girls, normal lipid values are given by age in both fasting and casual (nonfasting) states. This study group closely resembled a normal pediatric practice population, so that the values established may be used as baseline data for the practicing pediatrician. Since sex, race, and age are dominant sources for variations, care must be taken in the interpretation of minor changes that occur over time in a child.