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April 1984, Vol 138, No. 4 >
Article | April 1984

Serum Lipid and Lipoprotein Cholesterol Grids for Cardiovascular Risk Screening of Children FREE

James L. Cresanta, MD; Sathanur R. Srinivasan, PhD; Larry S. Webber, PhD; Gerald S. Berenson, MD
[+] Author Affiliations

Reprint requests to LSU Medical Center, Specialized Center of Research-Arteriosclerosis, 1542 Tulane Ave, New Orleans, LA 70112 (Dr Berenson).


Am J Dis Child. 1984;138(4):379-387. doi:10.1001/archpedi.1984.02140420045016.
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References
Comments

• We determined serum lipid and lipoprotein percentiles from a total community study of 5,250 fasting children (35% black, 65% white), aged 2 to 19 years. A serum turbidity index was used as a rapid, inexpensive screening test for hyper-β-lipoproteinemia and hyper-pre-β-lipoproteinemia. Percentile grids for the turbidity index and serum total cholesterol and β-lipoprotein cholesterol levels may be used for either black or white children. Triglyceride and pre-β-lipoprotein cholesterol level percentile grids were reported by race because of lower levels in black children, while grids for α-lipoprotein cholesterol levels were reported separately by sex for black and white subjects. A five-step method was outlined for screening children for lipid and lipoprotein abnormalities. Those with hyper-β-lipoproteinemia and hyperpre-β-lipoproteinemia would be candidates for therapy and indicate screening of other family members, after secondary causes are excluded.

(AJDC 1984;138:379-387)

REFERENCES

1 +
Lauer RM, Connor WE, Leaverton PE, et al:  Coronary heart disease risk factors in school children: The Muscatine Study . J Pediatr 1975;;86:697-706.
2 +
Frerichs RR, Srinivasan SR, Webber LS, et al:  Serum cholesterol and triglyceride levels in 3,446 children from a biracial community: The Bogalusa heart study . Circulation 1976;;54: 302-309.
3 +
Srinivasan SR, Frerichs RR, Webber LS, et al:  Serum lipoprotein profile in children from a biracial community: The Bogalusa heart study . Circulation 1976;;54:309-318.
4 +
Morrison JA, deGroot I, Edwards BK, et al:  Plasma cholesterol and triglyceride levels in 6,775 school children, ages 6-17 . Metabolism 1977;;26:1199-1211.
5 +
Morrison JA, deGroot I, Edwards BK, et al:  Lipids and lipoproteins in 927 school children, ages 6-17 years . Pediatrics 1978;;62:990-995.
6 +
Ellefson RD, Elveback LR, Hodgson PA, et al:  Cholesterol and triglycerides in serum lipoproteins of young persons in Rochester, Minnesota . Mayo Clin Proc 1978;;53:307-320.
7 +
Berenson GS, McMahan CA, Voors AW, et al: Cardiovascular Risk Factors in Children: The Early Natural History of Atherosclerosis and Essential Hypertension . New York, Oxford University Press, 1980;.
8 +
Berenson GS, Srinivasan SR, Cresanta JL, et al:  Dynamic changes of serum lipoproteins in children during adolescence and sexual maturation . Am J Epidemiol 1981;;113:157-170.
9 +
Cresanta JL, Srinivasan SR, Foster TA, et al:  Serum lipoprotein levels in children: Epidemiologic and clinical implications . J Chronic Dis 1982;;35:41-51.
10 +
Cresanta JL, Srinivasan SR, Foster TA, et al:  Distributions of serum lipoproteins in children by repeated measurements . Prev Med 1983;;12:554-568.
11 +
National Center for Health Statistics: Total Serum Cholesterol Values of Youths 12-17 Years . US Vital and Health Statistics, series 11, No. 156, Department of Health, Education, and Welfare publication (HRA) 76-1638, 1976;.
12 +
National Center for Health Statistics: Total Serum Cholesterol Levels of Children 4-17 Years . US Vital and Health Statistics, series 11, No. 207, Department of Health, Education, and Welfare publication (PHS) 78-1655, 1978;.
13 +
Lipid Research Clinics: Population Studies Data Book . Department of Health and Human Services (NIH) 80-1527, 1980;, vol 1: The Prevalence Study.
14 +
Tamir I, Heiss G, Glueck CJ, et al:  Lipid and lipoprotein distributions in white children ages 6-19 yr: The lipid research clinics program prevalence study . J Chronic Dis 1981;;34:27-39.
15 +
National Center for Health Statistics: Vital Statistics of the United States , 1978;. Department of Health and Human Services publication (PHS) 82-1102. Public Health Service, 1982, vol 2,  part B .
16 +
Srinivasan SR, Lopez S-A, Radhakrishnamurthy B, et al:  A simplified technique for semi-quantitative, clinical estimation of serum β- and pre-β-lipoproteins . Angiologica 1970;;7: 344-50.
17 +
Berenson GS, Srinivasan SR, Pargaonkar PS, et al:  A simplified primary screening procedure for detection of hyperlipidemias in healthy individuals . Clin Chem 1972;;18:1463-1467.
18 +
Srinivasan SR, Ellefson RD, Whitaker CF, et al:  Lipoprotein cholesterol in the serum of children, as determined independently by two different methods . Clin Chem 1978;;24:157-161.
19 +
Srinivasan SR, Foster TA, Berenson GS:  Comparability of results by simplified methods for measuring serum lipoprotein cholesterol in a pediatric population . Clin Chem 1980;;26:1548-1553.
20 +
Srinivasan SR, Berenson GS:  Serum lipoproteins in children and methods for study , in Lewis LA, Opplt JJ (eds): CRC Handbook of Electrophoresis (Lipoproteins) . Boca Raton, Fla, CRC Press, vol 3, 1983;, pp 185-203.
21 +
Frerichs RR, Srinivasan SR, Webber LS, et al:  Serum lipids and lipoproteins at birth in a biracial population: The Bogalusa heart study . Pediatr Res 1978;;12:858-863.
22 +
Berenson GS, Blonde CV, Farris RP, et al:  Cardiovascular disease risk factor variables during the first year of life . Am J Dis Child 1979;;133:1049-1057.
23 +
Berenson GS, Foster TA, Frank GC, et al:  Cardiovascular disease risk factor variables at the preschool age: The Bogalusa heart study . Circulation 1978;;57:603-612.
24 +
Foster TA, Webber LS, Srinivasan SR, et al:  Measurement error of risk factor variables in an epidemiologic study of children: The Bogalusa heart study . J Chronic Dis 1980;;33: 661-672.
25 +
SAS User's Guide, 1979 Edition . Raleigh, NC, SAS Institute Inc, 1979;.
26 +
Holman RL, McGill HC, Strong JP, et al:  The natural history of atherosclerosis: The early aortic lesions as seen in New Orleans in the middle of the 20th century . Am J Pathol 1958;;34:209-235.
27 +
Strong JP, McGill HC Jr:  Pediatric aspects of atherosclerosis . Atherosclerosis 1969;;9:25-65.
28 +
Newman WP III, Strong JP:  Natural history, geographic pathology , and pediatric aspects of atherosclerosis, in Strong WB (ed): Atherosclerosis : Its Pediatric Aspects. New York, Grune & Stratton Inc, 1978;, pp 15-40.
29 +
Gardner MJ, Heady JA:  Some effects of within-person variability in epidemiological studies . J Chronic Dis 1973;;26:781-795.
30 +
McMahan CA:  An assessment of laboratory measurement error of lipids and lipoproteins for a total community study , in Berenson GS, McMahan CA, Voors AW, et al (eds): Cardiovascular Risk Factors in Children: The Early Natural History of Atherosclerosis and Essential Hypertension . New York, Oxford University Press, 1980;, pp 61-85.
31 +
Morrison JA, Laskarzewski P, deGroot I, et al:  Diagnostic ramifications of repeated plasma cholesterol and triglyceride measurements in children: Regression toward the mean in a pediatric population . Pediatrics 1979;;64:197-201.
32 +
Foster TA, Voors AW, Webber LS, et al:  Anthropometric and maturation measurements of children, ages 5 to 14 years, in a biracial community: The Bogalusa heart study . Am J Clin Nutr 1977;;30:582-591.
33 +
Berenson GS, Epstein FH: Conference on blood lipids in children: Optimal levels for early prevention of coronary artery disease. Prev Med, in press.
34 +
Kannel WB, Dawber TR:  Atherosclerosis as a pediatric problem . J Pediatr 1972;;80:544-554.
35 +
Drash A:  Atherosclerosis, cholesterol, and the pediatrician . J Pediatr 1972;;80:693-696.
36 +
Tsang RC, Glueck CJ:  Atherosclerosis: A pediatric perspective . Curr Probl Pediatr 1979;;9:1-38.
37 +
Levy RI:  Cholesterol, lipoproteins, apoproteins, and heart disease: Present status and future prospects . Clin Chem 1981;;27:653-662.
38 +
Probstfield JC, Gotto AM Jr:  Lipoproteins in health and disease: Diagnosis and management . Baylor Coll Med Cardiol Ser 1982;;5:6-27.
39 +
 Conference on the health effects of blood lipids: Optimal distributions for populations . Prev Med 1979;;8:580-759.
40 +
Grundy SM, Bilheimer D, Blackburn H, et al:  Rationale of the diet-heart statement of the American Heart Association . Circulation 1982;; 65:839A-854A.
41 +
Tyroler HA, Hames CG, Krishan I, et al:  Black-white differences in serum lipids and lipoproteins in Evans County . Prev Med 1975;;4:541-549.
42 +
Heiss G, Tyroler HA, Hames C:  Cholesterol tracking: Prediction over time of serum cholesterol in Evans County , Ga. Adv Exp Med Biol 1977;;82:112-114.
43 +
Clarke WR, Schrott HG, Leaverton PE, et al:  Tracking of blood lipids and blood pressure in school age children: The Muscatine study . Circulation 1978;;58:626-634.
44 +
Laskarzewski P, Morrison JA, deGroot I, et al:  Lipid and lipoprotein tracking in 108 children over a four-year period . Pediatrics 1979;;64: 584-591.
45 +
Frerichs RR, Webber LS, Voors AW, et al:  Cardiovascular disease risk factor variables in children at two successive years: The Bogalusa heart study . J Chronic Dis 1979;;32:251-262.
46 +
Webber LS, Srinivasan SR, Voors AW, et al:  Persistence of levels for risk factor variables during the first year of life: The Bogalusa heart study . J Chronic Dis 1980;;33:157-167.
47 +
Webber LS, Cresanta JL, Voors AW, et al:  Tracking of cardiovascular disease risk factor variables in school-age children . J Chronic Dis 1983;;36:647-660.
48 +
Kwiterovich PO, Heiss G, Johnson N, et al:  Assessment of plasma total cholesterol as a test to detect elevated low density (beta) lipoprotein cholesterol levels (type IIa hyperlipoproteinemia) in young subjects from a population-based sample . Am J Epidemiol 1982;;115:192-204.
49 +
Srinivasan SR, Foster TA, Berenson GS:  Efficacy of a simplified primary screening procedure for detection of hyperlipoproteinemias in a pediatric population . Clin Chem 1979;;25:242-246.
50 +
Berwick DM, Cretin S, Keeler E:  Cholesterol, children, and heart disease: An analysis of alternatives . Pediatrics 1981;;68:721-730.

Figures

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Interactive Graphics

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Lauer RM, Connor WE, Leaverton PE, et al:  Coronary heart disease risk factors in school children: The Muscatine Study . J Pediatr 1975;;86:697-706.
2 +
Frerichs RR, Srinivasan SR, Webber LS, et al:  Serum cholesterol and triglyceride levels in 3,446 children from a biracial community: The Bogalusa heart study . Circulation 1976;;54: 302-309.
3 +
Srinivasan SR, Frerichs RR, Webber LS, et al:  Serum lipoprotein profile in children from a biracial community: The Bogalusa heart study . Circulation 1976;;54:309-318.
4 +
Morrison JA, deGroot I, Edwards BK, et al:  Plasma cholesterol and triglyceride levels in 6,775 school children, ages 6-17 . Metabolism 1977;;26:1199-1211.
5 +
Morrison JA, deGroot I, Edwards BK, et al:  Lipids and lipoproteins in 927 school children, ages 6-17 years . Pediatrics 1978;;62:990-995.
6 +
Ellefson RD, Elveback LR, Hodgson PA, et al:  Cholesterol and triglycerides in serum lipoproteins of young persons in Rochester, Minnesota . Mayo Clin Proc 1978;;53:307-320.
7 +
Berenson GS, McMahan CA, Voors AW, et al: Cardiovascular Risk Factors in Children: The Early Natural History of Atherosclerosis and Essential Hypertension . New York, Oxford University Press, 1980;.
8 +
Berenson GS, Srinivasan SR, Cresanta JL, et al:  Dynamic changes of serum lipoproteins in children during adolescence and sexual maturation . Am J Epidemiol 1981;;113:157-170.
9 +
Cresanta JL, Srinivasan SR, Foster TA, et al:  Serum lipoprotein levels in children: Epidemiologic and clinical implications . J Chronic Dis 1982;;35:41-51.
10 +
Cresanta JL, Srinivasan SR, Foster TA, et al:  Distributions of serum lipoproteins in children by repeated measurements . Prev Med 1983;;12:554-568.
11 +
National Center for Health Statistics: Total Serum Cholesterol Values of Youths 12-17 Years . US Vital and Health Statistics, series 11, No. 156, Department of Health, Education, and Welfare publication (HRA) 76-1638, 1976;.
12 +
National Center for Health Statistics: Total Serum Cholesterol Levels of Children 4-17 Years . US Vital and Health Statistics, series 11, No. 207, Department of Health, Education, and Welfare publication (PHS) 78-1655, 1978;.
13 +
Lipid Research Clinics: Population Studies Data Book . Department of Health and Human Services (NIH) 80-1527, 1980;, vol 1: The Prevalence Study.
14 +
Tamir I, Heiss G, Glueck CJ, et al:  Lipid and lipoprotein distributions in white children ages 6-19 yr: The lipid research clinics program prevalence study . J Chronic Dis 1981;;34:27-39.
15 +
National Center for Health Statistics: Vital Statistics of the United States , 1978;. Department of Health and Human Services publication (PHS) 82-1102. Public Health Service, 1982, vol 2,  part B .
16 +
Srinivasan SR, Lopez S-A, Radhakrishnamurthy B, et al:  A simplified technique for semi-quantitative, clinical estimation of serum β- and pre-β-lipoproteins . Angiologica 1970;;7: 344-50.
17 +
Berenson GS, Srinivasan SR, Pargaonkar PS, et al:  A simplified primary screening procedure for detection of hyperlipidemias in healthy individuals . Clin Chem 1972;;18:1463-1467.
18 +
Srinivasan SR, Ellefson RD, Whitaker CF, et al:  Lipoprotein cholesterol in the serum of children, as determined independently by two different methods . Clin Chem 1978;;24:157-161.
19 +
Srinivasan SR, Foster TA, Berenson GS:  Comparability of results by simplified methods for measuring serum lipoprotein cholesterol in a pediatric population . Clin Chem 1980;;26:1548-1553.
20 +
Srinivasan SR, Berenson GS:  Serum lipoproteins in children and methods for study , in Lewis LA, Opplt JJ (eds): CRC Handbook of Electrophoresis (Lipoproteins) . Boca Raton, Fla, CRC Press, vol 3, 1983;, pp 185-203.
21 +
Frerichs RR, Srinivasan SR, Webber LS, et al:  Serum lipids and lipoproteins at birth in a biracial population: The Bogalusa heart study . Pediatr Res 1978;;12:858-863.
22 +
Berenson GS, Blonde CV, Farris RP, et al:  Cardiovascular disease risk factor variables during the first year of life . Am J Dis Child 1979;;133:1049-1057.
23 +
Berenson GS, Foster TA, Frank GC, et al:  Cardiovascular disease risk factor variables at the preschool age: The Bogalusa heart study . Circulation 1978;;57:603-612.
24 +
Foster TA, Webber LS, Srinivasan SR, et al:  Measurement error of risk factor variables in an epidemiologic study of children: The Bogalusa heart study . J Chronic Dis 1980;;33: 661-672.
25 +
SAS User's Guide, 1979 Edition . Raleigh, NC, SAS Institute Inc, 1979;.
26 +
Holman RL, McGill HC, Strong JP, et al:  The natural history of atherosclerosis: The early aortic lesions as seen in New Orleans in the middle of the 20th century . Am J Pathol 1958;;34:209-235.
27 +
Strong JP, McGill HC Jr:  Pediatric aspects of atherosclerosis . Atherosclerosis 1969;;9:25-65.
28 +
Newman WP III, Strong JP:  Natural history, geographic pathology , and pediatric aspects of atherosclerosis, in Strong WB (ed): Atherosclerosis : Its Pediatric Aspects. New York, Grune & Stratton Inc, 1978;, pp 15-40.
29 +
Gardner MJ, Heady JA:  Some effects of within-person variability in epidemiological studies . J Chronic Dis 1973;;26:781-795.
30 +
McMahan CA:  An assessment of laboratory measurement error of lipids and lipoproteins for a total community study , in Berenson GS, McMahan CA, Voors AW, et al (eds): Cardiovascular Risk Factors in Children: The Early Natural History of Atherosclerosis and Essential Hypertension . New York, Oxford University Press, 1980;, pp 61-85.
31 +
Morrison JA, Laskarzewski P, deGroot I, et al:  Diagnostic ramifications of repeated plasma cholesterol and triglyceride measurements in children: Regression toward the mean in a pediatric population . Pediatrics 1979;;64:197-201.
32 +
Foster TA, Voors AW, Webber LS, et al:  Anthropometric and maturation measurements of children, ages 5 to 14 years, in a biracial community: The Bogalusa heart study . Am J Clin Nutr 1977;;30:582-591.
33 +
Berenson GS, Epstein FH: Conference on blood lipids in children: Optimal levels for early prevention of coronary artery disease. Prev Med, in press.
34 +
Kannel WB, Dawber TR:  Atherosclerosis as a pediatric problem . J Pediatr 1972;;80:544-554.
35 +
Drash A:  Atherosclerosis, cholesterol, and the pediatrician . J Pediatr 1972;;80:693-696.
36 +
Tsang RC, Glueck CJ:  Atherosclerosis: A pediatric perspective . Curr Probl Pediatr 1979;;9:1-38.
37 +
Levy RI:  Cholesterol, lipoproteins, apoproteins, and heart disease: Present status and future prospects . Clin Chem 1981;;27:653-662.
38 +
Probstfield JC, Gotto AM Jr:  Lipoproteins in health and disease: Diagnosis and management . Baylor Coll Med Cardiol Ser 1982;;5:6-27.
39 +
 Conference on the health effects of blood lipids: Optimal distributions for populations . Prev Med 1979;;8:580-759.
40 +
Grundy SM, Bilheimer D, Blackburn H, et al:  Rationale of the diet-heart statement of the American Heart Association . Circulation 1982;; 65:839A-854A.
41 +
Tyroler HA, Hames CG, Krishan I, et al:  Black-white differences in serum lipids and lipoproteins in Evans County . Prev Med 1975;;4:541-549.
42 +
Heiss G, Tyroler HA, Hames C:  Cholesterol tracking: Prediction over time of serum cholesterol in Evans County , Ga. Adv Exp Med Biol 1977;;82:112-114.
43 +
Clarke WR, Schrott HG, Leaverton PE, et al:  Tracking of blood lipids and blood pressure in school age children: The Muscatine study . Circulation 1978;;58:626-634.
44 +
Laskarzewski P, Morrison JA, deGroot I, et al:  Lipid and lipoprotein tracking in 108 children over a four-year period . Pediatrics 1979;;64: 584-591.
45 +
Frerichs RR, Webber LS, Voors AW, et al:  Cardiovascular disease risk factor variables in children at two successive years: The Bogalusa heart study . J Chronic Dis 1979;;32:251-262.
46 +
Webber LS, Srinivasan SR, Voors AW, et al:  Persistence of levels for risk factor variables during the first year of life: The Bogalusa heart study . J Chronic Dis 1980;;33:157-167.
47 +
Webber LS, Cresanta JL, Voors AW, et al:  Tracking of cardiovascular disease risk factor variables in school-age children . J Chronic Dis 1983;;36:647-660.
48 +
Kwiterovich PO, Heiss G, Johnson N, et al:  Assessment of plasma total cholesterol as a test to detect elevated low density (beta) lipoprotein cholesterol levels (type IIa hyperlipoproteinemia) in young subjects from a population-based sample . Am J Epidemiol 1982;;115:192-204.
49 +
Srinivasan SR, Foster TA, Berenson GS:  Efficacy of a simplified primary screening procedure for detection of hyperlipoproteinemias in a pediatric population . Clin Chem 1979;;25:242-246.
50 +
Berwick DM, Cretin S, Keeler E:  Cholesterol, children, and heart disease: An analysis of alternatives . Pediatrics 1981;;68:721-730.

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