Abstract
Background: Non-high-density lipoprotein cholesterol (non-HDL-C) is now recognized as strongly predictive of cardiovascular disease in adults, and was recommended as the secondary lipid management goal in Japanese atherosclerosis society guidelines for the diagnosis and prevention of atherosclerotic cardiovascular disease. However, there have only been a few reports about that in children.
Methods: 5,853 fourth and seventh grade schoolchildren were included in the screening for lifestyle-related disease from 2010 to 2011 in Takaoka City, and received anthropometric measurements and blood tests for total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) levels. The relationship between the percentage overweight (POW) values and the levels of each lipid was analyzed, and children above the 97th percentile of levels of TC (220mg/dl) and non-HDL-C (152mg/dl) were closely compared and assessed. Among the reexamined 150 obese children, the relationship between the prevalence of metabolic syndrome and non-HDL-C levels was analyzed.
Results: Non-HDL-C was positively correlated with POW and TG more so than TC (r = 0.273, 0.360 vs. 0.118, 0.179, all P < 0.001). In the screening for TC, several subjects with high HDL-C subjects were incorrectly categorized. Consequently, the sensitivity of identifying high LDL-C subjects was lower using TC levels than non-HDL-C levels for screening (80.8% vs.98.3%). The prevalence of metabolic syndrome increased significantly when non-HDL-C levels were elevated in re-examined obese children (P = 0.009).
Conclusion: Non-HDL-C levels rather than TC levels will serve as a better screening tool for lifestyle-related disease in schoolchildren.
