Document Type : Research articles

Authors

1 Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 . MSc. in Educational Psychology, Department of psychology, Yazd University, Yazd, Iran

3 1. Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

4 Department of Occupational Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Abstract

Abstract
Background: Dyslipidemia, a genetic and multifactorial disorder of lipoprotein metabolism, is defined by elevations in the levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), triglyceride, or some combination thereof as well as lower levels of high-density lipoprotein (HDL) cholesterol.
Objectives: This study aimed to investigate the prevalence and predictors of dyslipidemia in children and adolescents in the Yazd Greater Area, Yazd, Iran.
Methods: This cross-sectional study was conducted as a part of the national project implemented in Yazd Greater Area, Yazd, Iran. The sampling was performed using a multi-stage cluster sampling method on three age groups of girls and boys, including 6-9, 10-14, and 15-18 years old. Out of the total 1,035 children and adolescents who initially participated in this study, only 784 participants remained until the end. Data collection was performed using lifestyle questionnaires including Kiddie-SADS-Present and Lifetime Version software.
Results: The rate of high triglyceride was estimated at 1.4% and 4.2% in 6-9 and 10-18 years old children and adolescents, respectively. Moreover, the prevalence of high cholesterol, LDL, and HDL were obtained at 3.2%, 3.2%, and 25.6%, respectively. The prevalence of dyslipidemia in the total population of children and adolescents was estimated at 64.6% and 57.3% in boys and girls, respectively (P=0.038) in terms of demographic variables. Gender and increase in body mass index (BMI) were significantly associated with dyslipidemia with OR=1.35; 95% CI: 1.01-1.81 and OR=13.781; 95% CI: 3.78- 46.43, respectively. However, after adjustment for other factors, only an increase in BMI was significantly associated with dyslipidemia (OR=16.08; 95% CI: 4.49-57.59).
Conclusion: Overweight and obese adolescents had a higher concentration of serum blood triglycerides, compared to their counterparts. Weight control, lifestyle, and diet modification are three ways to reduce lipid disorders in adolescents.

Keywords

  1. Fahimfar N, Khalili D, Sepanlou SG, Malekzadeh R, Azizi F, Mansournia MA, et al. Cardiovascular mortality in a Western Asian country: results from the Iran Cohort Consortium. BMJ Open. 2018;8(7):e020303. doi: 10.1136/bmjopen-2017-020303. [PubMed: 29980541].
  2. Kaestner TL, Santos JAD, Pazin DC, Baena CP, Olandoski M, Abreu GA, et al. Prevalence of combined lipid abnormalities in brazilian adolescents and its association with nutritional status: data from the erica study. Glob Heart. 2020;15(1):23. doi: 10.5334/gh.769. [PubMed: 32489796].
  3. Elkins C, Fruh S, Jones L, Bydalek K. Clinical practice recommendations for pediatric dyslipidemia. J Pediatr Heal Care. 2019;33(4):494-504. doi: 10.1016/j.pedhc.2019.02.009. [PubMed: 31227123].
  4. Lozano P, Henrikson NB, Morrison CC, Dunn J, Nguyen M, Blasi PR, et al. Lipid screening in childhood and adolescence for detection of multifactorial dyslipidemia: Evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2016;316(6):634-44. doi: 10.1001/jama.2016.6423. [PubMed: 27532918].
  5. Cook S, Auinger P, Huang TTK. Growth curves for cardio-metabolic risk factors in children and adolescents. J Pediatr. 2009;155(3):S6.e15-26. doi: 10.1016/j.jpeds.2009.04.051. [PubMed: 19732566].
  6. Center for Disease Control and Prevention (CDC). Morbidity and mortality weekly report prevalence of abnormal lipid levels among youths --- United States , 1999–2006. MMWR Morb Mortal Wkly Rep. 2010;59(2):29-33. [PubMed: 20094024].
  7. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, et al. Screening for lipid disorders in children and adolescents US Preventive Services Task Force recommendation statement. JAMA. 2016;316(6):625-33. doi: 10.1001/jama.2016.9852. [PubMed: 27532917].
  8. Nielsen TRH, Lausten-Thomsen U, Fonvig CE, Bøjsøe C, Pedersen L, Bratholm PS, et al. Dyslipidemia and reference values for fasting plasma lipid concentrations in Danish/North-European White children and adolescents. BMC Pediatr. 2017;17(1):116. doi: 10.1186/s12887-017-0868-y. [PubMed: 28454530].
  9. Angelini V, Klijs B, Smidt N, Mierau JO. Associations between childhood Parental mental health difficulties and depressive symptoms in late adulthood: The influence of life-course socioeconomic, health and lifestyle factors. PLoS One. 2016;11(12):e0167703. doi: 10.1371/journal.pone.0167703. [PubMed: 27936078].
  10. Genovesi S, Giussani M, Orlando A, Battaglino MG, Nava E, Parati G. Prevention of cardiovascular diseases in children and adolescents. High Blood Press Cardiovasc Prev. 2019;26(3):191-7. doi: 10.1007/s40292-019-00316-6. [PubMed: 31041682].
  11. Gooding HC, de Ferranti SD. Cardiovascular risk assessment and cholesterol management in adolescents: getting to the heart of the matter. Curr Opin Pediatr. 2010;22(4):398-404. doi: 10.1097/MOP.0b013e32833a6e22. [PubMed: 20489635].
  12. de Ferranti SD, Rodday AM, Parsons SK, Cull WL, O’Connor KG, Daniels SR, et al. Cholesterol screening and treatment practices and preferences: a survey of united states pediatricians. J Pediatr. 2017;185:99-105.e2. doi: 10.1016/j.jpeds.2016.12.078. [PubMed: 28209292].
  13. Mohammadi MR, Ahmadi N, Kamali K, Khaleghi A, Ahmadi A. Epidemiology of psychiatric disorders in iranian children and adolescents and its relationship with social capital, life style and parents’ personality disorders: Study protocol. Iran J Psychiatry. 2017;12(1):66-72. [PubMed: 28496504].
  14. Saunders W. Nelson textbook of paediatrics. Arch Dis Child. 1983;58(11):942. doi: 10.1136/adc.58.11.942-b. [PubMed: 21032695].
  15. Jarbin H, Andersson M, Råstam M, Ivarsson T. Predictive validity of the K-SADS-PL 2009 version in school-aged and adolescent outpatients. Nord J Psychiatry. 2017;71(4):270-6. doi: 10.1080/08039488.2016.1276622. [PubMed: 28413935].
  16. Ghanizadeh A, Mohammadi MR, Yazdanshenas A. Psychometric properties of the Farsi translation of the kiddie schedule for affective disorders and schizophrenia-present and lifetime version. BMC Psychiatry. 2006;6:10. doi: 10.1186/1471-244X-6-10. [PubMed: 16539703].
  17. Lali M, Abedi A, Kajbaf MB. Construction and validation of the lifestyle questionnaire (LSQ). Psychol Res. 2012;15(1):64-80.
  18. Taheri F, Kazemi T, Bijari B, Namakin K, Zardast M, Chahkandi T. Prevalence of dyslipidemia among elementary school children in Birjand, East of Iran, 2012. 2016;11(1):15-20. [PubMed: 27403185].
  19. Kit BK, Kuklina E, Carroll MD, Ostchega Y, Freedman DS, Ogden CL. Prevalence of and trends in dyslipidemia and blood pressure among us children and adolescents, 1999-2012. JAMA Pediatr. 2015;169(3):272–9. doi: 10.1001/jamapediatrics.2014.3216. [PubMed: 25599372].
  20. Korsten-Reck U, Kromeyer-Hauschild K, Korsten K, Baumstark MW, Dickhuth HH, Berg A. Frequency of secondary dyslipidemia in obese children. Vasc Health Risk Manag. 2008;4(5):1089-94. doi: 10.2147/vhrm.s2928. [PubMed: 19183757].
  21. Ford ES, Li C, Zhao G, Mokdad AH. Concentrations of low-density lipoprotein cholesterol and total cholesterol among children and adolescents in the united states. Circulation. 2009;119(8):1108-15. doi: 10.1161/CIRCULATIONAHA.108.816769. [PubMed: 19221218].
  22. Hovsepian S, Kelishadi R, Djalalinia S, Farzadfar F, Naderimagham S, Qorbani M. Prevalence of dyslipidemia in Iranian children and adolescents: a systematic review. J Res Med Sci. 2015;20(5):503-21. doi: 10.4103/1735-1995.163979. [PubMed: 26487880].
  23. Zanoni P, Khetarpal SA, Larach DB, Hancock-Cerutti WF, Millar JS, Cuchel M, et al. Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease. Science. 2016;351(6278):1166-71. doi: 10.1126/science.aad3517. [PubMed: 26965621].
  24. Kim SH, Ahn BC, Joung H, Park MJ. Lipid profiles and prevalence of dyslipidemia in Korean adolescents. Endocrinol Metab. 2012;27(3):208-16. doi: 10.3803/EnM.2012.27.3.208.
  25. Hashemipour M, Soghrati M, Ahmadi MM, Soghrati M. Anthropometric indices associated with dyslipidemia in obese children and adolescents: a retrospective study in Isfahan. ARYA Atheroscler. 2011;7(1):31–9. [PubMed: 22577442].