Document Detail


Evaluation of AAP guidelines for cholesterol screening in youth: Project HeartBeat!
MedLine Citation:
PMID:  19524159     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The American Academy of Pediatrics (AAP) criterion for screening for hypercholesterolemia in children is family history of hypercholesterolemia or cardiovascular disease or BMI > or =85th percentile. This paper aims to determine the sensitivity, specificity, and positive predictive value (PPV) of dyslipidemia screening using AAP criteria along with either family history or BMI. METHODS: Height, weight, plasma total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and family history were obtained for 678 children aged 8, 11, and 14 years, enrolled from 1991 to 1993 in Project HeartBeat!. Sensitivity, specificity, and PPV screening of each lipid component using family history alone, BMI > or =85th percentile alone, or family history and/or BMI > or =85th percentile, were calculated using 2008 AAP criteria (total cholesterol, LDL-C, and triglycerides > or =90th percentile; HDL-C <10th percentile). RESULTS: Sensitivity of detecting abnormal total cholesterol, LDL-C, HDL-C, and triglycerides using family history alone ranged from 38% to 43% and significantly increased to 54%-66% using family history and/or BMI. Specificity significantly decreased from approximately 65% to 52%, and there were no notable changes in PPV. In black children, cholesterol screening using the BMI > or =85th percentile criterion had higher sensitivity than when using the family history criterion. In nonblacks, family history and/or BMI > or =85th percentile had greater sensitivity than family history alone. CONCLUSIONS: When the BMI screening criterion was used along with the family history criterion, sensitivity increased, specificity decreased, and PPV changed trivially for detection of dyslipidemia. Despite increased screening sensitivity by adding the BMI criterion, a clinically significant number of children still may be misclassified.
Authors:
Mona A Eissa; Eugene Wen; Nicole L Mihalopoulos; Jo Anne Grunbaum; Darwin R Labarthe
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of preventive medicine     Volume:  37     ISSN:  1873-2607     ISO Abbreviation:  Am J Prev Med     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-15     Completed Date:  2009-08-31     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  8704773     Medline TA:  Am J Prev Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  S71-7     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Medical School, University of Texas Health Science Center at Houston, 6431 Fannin, Houston, TX 77030, USA. Mona.A.Eissa@uth.tmc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
African Continental Ancestry Group / statistics & numerical data
Body Mass Index*
Child
Cholesterol / blood*
Continental Population Groups / statistics & numerical data
Female
Humans
Hypercholesterolemia / diagnosis*
Longitudinal Studies
Male
Mass Screening / methods*
Practice Guidelines as Topic*
Predictive Value of Tests
Sensitivity and Specificity
Societies, Medical
United States
Grant Support
ID/Acronym/Agency:
U01 HL041166-05/HL/NHLBI NIH HHS; U01-HL-41166/HL/NHLBI NIH HHS; U48/CCU609653//PHS HHS
Chemical
Reg. No./Substance:
57-88-5/Cholesterol
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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