Proposition of decision limits for serum lipids in Brazilian children aged one to 13 years

• Published in: Jornal de pediatria Vol. 95; no. 2; pp. 173 - 179
• Main Authors: Slhessarenko, Natasha, Fontes, Cor J.F., Slhessarenko, Maria Eduarda, Azevedo, Raymundo S., Andriolo, Adagmar
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier Editora Ltda 01.03.2019; Sociedade Brasileira de Pediatria; Elsevier
• Subjects: Adolescentes; Adolescents; Brazil; Child; Child, Preschool; Children; Cholesterol - blood; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Crianças; Cross-Sectional Studies; Decision limits; Female; Humans; Infant; Intervalos de referência; Limites de decisão; Lipids - blood; Lípides séricos; Male; Nutritional Status; PEDIATRICS; Reference intervals; Reference Values; Serum lipids; Triglycerides - blood; Brazil; Serum lipids; Lípides séricos; Adolescentes; Children; Decision limits; Adolescents; Crianças; Limites de decisão; Reference intervals; Intervalos de referência
• ISSN: 0021-7557; 1678-4782; 1678-4782
• DOI: 10.1016/j.jped.2018.01.003

To determine decision limits for total cholesterol, LDL-cholesterol, non-HDL cholesterol, HDL-cholesterol, and triglycerides in healthy children and adolescents from Cuiabá, Brazil. This was a cross-sectional study of 1866 healthy children and adolescents randomly selected from daycare centers and public schools in Cuiabá. The desirable levels of serum lipids were defined using the classic criteria, i.e., total cholesterol, LDL-cholesterol, non-HDL cholesterol, and triglycerides levels below the P75 percentile, and HDL-c above the P10 percentile. For CT, P75 was: 160mg/dL for the age range of 1 to <3 years, 170mg/dL for ≥3 to <9 years, and 176mg/dL for ≥9 to <13 years. For non-HDL cholesterol, it was 122mg/dL for the age range of 1 to <13 years. For LDL-c, it was 104mg/dL at the age range of 1 to <9 years and 106mg/dL from ≥9 to <13 years. For TG, it was 127mg/dL from 1 to <2 years; 98mg/dL from ≥2 to <6 years; and 92mg/dL from ≥6 to <13 years. As for HDL-cholesterol, P10 was 24mg/dL, 28mg/dL, 32mg/dL, and 36mg/dL, for the age ranges of 1 to <2 years, ≥2 to <3 years, ≥3 to <4 years, and ≥4 to <13 years, respectively. The decision limits for the serum lipid levels defined in this study differed from those observed in the current Brazilian and North-American guidelines, especially because it differentiates between the age ranges. Using these decision limits in clinical practice will certainly contribute to improve the diagnostic accuracy for dyslipidemia in this population group. Determinar limites de decisão (LD) para o colesterol total (CT), LDL-colesterol (LDL-c), colesterol não-HDL (c-NHDL), HDL-colesterol (HDL-c) e triglicérides (TG) em crianças e adolescentes saudáveis de Cuiabá. Estudo transversal envolvendo 1.866 crianças e adolescentes saudáveis de creches e escolas municipais públicas de Cuiabá, aleatoriamente selecionadas. Os LD desejáveis dos lipídeos séricos foram definidos pelos critérios clássicos, isto é, níveis de CT, LDL-c, c-NHDL, TG abaixo do percentil 75, e de HDL-c acima do percentil 10. Os P75 para CT foram: 160mg/dL para a faixa etária de 1 a < 3 anos, 170mg/dL para ≥ 3 a < 9 anos e 176mg/dL para ≥ 9 a < 13 anos. Para o c-NHDL, de 122mg/dL na faixa etária de 1 a <13 anos. LDL-c: 104mg/dL na faixa etária de 1 a < 9 anos e 106mg/dL de ≥ 9 a < 13 anos. TG: 127mg/dL entre 1 a < 2 anos; 98mg/dL de ≥ 2 a < 6 anos; e 92mg/dL de ≥ 6 a < 13 anos. Quanto ao HDL-c, o P10, foi de 24mg/dL, 28mg/dL, 32mg/dL e 36mg/dL, para as faixas etárias de 1 a < 2 anos, ≥ 2 a < 3 anos, ≥ 3 a < 4 anos e ≥ 4 a < 13 anos, respectivamente. Os LD dos níveis séricos de lipídeos definidos neste estudo diferem daqueles apresentados nas diretrizes brasileiras e americanas atuais, especialmente por fazer a diferenciação entre as idades. Utilizar tais LD em nossa prática clínica certamente contribuirá para melhorar a acurácia do diagnóstico de dislipidemia nesse grupo populacional.