Cholesterol In Adolescents Research Articles

Low-density lipoprotein cholesterol in adolescents and young adults with type 1 diabetes: Data from the Australasian Diabetes Data Network registry.

To determine low-density lipoprotein cholesterol (LDL-C) screening frequency and levels, and factors associated with elevated LDL-C, in Australasian youth with type 1 diabetes (T1D). Data were extracted from the Australasian Diabetes Data Network (ADDN), a prospective clinical quality registry, on all T1D healthcare visits attended by young people aged 16-25 years (with T1D duration of >1 year) between January 2011 and December 2020. The primary outcomes were elevated LDL-C > 2.6 mmol/L (100 mg/dL) and threshold for treatment: >3.4 mmol/L (130 mg/dL), according to consensus guidelines. Multivariable Generalised Estimated Equations (GEE) were used to examine factors associated with elevated LDL-C across all visits. A cohort of 6338 young people (52.6% men) were identified, of whom 1603 (25.3%) had ≥1 LDL-C measurement documented. At last measurement, mean age, age at T1D diagnosis and T1D duration were 18.3 ± 2.4, 8.8 ± 4.5 and 8.9 ± 4.8 years, respectively. LDL-C was elevated in 737 (46.0%) and at the treatment threshold in 250 (15.6%). In multivariable GEE elevated LDL-C continuously was associated with older age (OR = 0.07; 0.01-0.13, p = 0.02), female sex (OR = 0.31; 0.18-0.43; p < 0.001), higher HbA1c (OR = 0.04; 0.01-0.08; p = 0.01) and having an elevated BMI (OR = 0.17, 0.06-0.39, p < 0.001). LDL-C screening and levels are suboptimal in this cohort, increasing future cardiovascular complication risk. There is an urgent need to understand how healthcare services can support improved screening and management of dyslipidaemia in this population.

Prospective Association Between Video and Computer Game Use During Adolescence and Incidence of Metabolic Health Risks: Secondary Data Analysis.

Video and computer games are popular activities, with 72% of adolescents aged 13 to 17 years reporting video game use on either a computer, game console, or portable device. Despite high levels of video and computer game use in adolescence, relatively little scientific literature exists examining the association and effects of video and computer games on adolescents. The objective of this study was to examine the prevalence of video and computer game use among US adolescents and rates of positive screens for obesity, diabetes, high blood pressure (BP), and high cholesterol. A secondary data analysis was conducted using the National Longitudinal Study of Adolescent to Adult Health (Add Health) data, including adolescents aged 12 to 19 years between 1994 and 2018. Respondents (n=4190) who played the most video and computer games had a significantly (P=.02) higher BMI and were more likely to self-report having at least one of the evaluated metabolic disorders: obesity (BMI >30 kg/m2), diabetes, high BP (BP >140/90), and high cholesterol (>240). With increased video or computer game use, there was a statistically significant increase in high BP rates in each quartile, with those with more frequent use also having higher rates of high BP. A similar trend was observed for diabetes, though the association did not reach statistical significance. No significant association was observed between video or computer game use and diagnoses of dyslipidemia, eating disorders, or depression. Frequency of video and computer game use is associated with obesity, diabetes, high BP, and high cholesterol in adolescents aged 12 to 19 years. Adolescents who play the most video and computer games have a significantly higher BMI. They are more likely to have at least one of the evaluated metabolic disorders: diabetes, high BP, or high cholesterol. Public health interventions designed to target modifiable disease states through health promotion and self-management may support the health of adolescents aged 12 to 19 years. Video and computer games can integrate health promotion interventions in gameplay. This is an important area for future research as video and computer games are integrated into the lives of adolescents.

Loss of Control Eating and Health Indicators Over 6 Years in Adolescents Undergoing Metabolic and Bariatric Surgery.

The aim of this study was to assess associations between loss of control (LOC) eating and health outcomes among adolescents undergoing metabolic and bariatric surgery. A total of 234 adolescents were studied before and up to 6 years after surgery in a prospective, observational cohort design. Adolescents provided self-reports of LOC eating, pain severity, sleep quality, polycystic ovary syndrome, gastroesophageal reflux disease, and medication usage and objective measures of fasting glucose, serum insulin, glycohemoglobin A1c , cholesterol, triglycerides, and blood pressure. χ2 tests, Wilcoxon rank sums, and generalized linear mixed models were used to assess concurrent and prospective associations between LOC eating and health indicators. LOC eating presented in 32.5% of adolescents before surgery and was positively associated with sleep disturbances and psychiatric medication usage. After surgery, LOC eating presented in 7.9% to 14.6% of participants and was correlated with improved low- and high-density lipoprotein cholesterol levels and greater back pain. LOC eating was inversely associated with low-density lipoprotein cholesterol at the next consecutive time point. LOC eating was unexpectedly associated with improved low- and high-density lipoprotein cholesterol in adolescents undergoing metabolic and bariatric surgery. Deleterious effects of LOC eating on obesity-related health conditions, aside from back pain, were not detected. Metabolic and other weight-independent health benefits of surgery may persist postoperatively despite LOC eating and associated weight regain.

Attention-deficit/hyperactivity disorder is associated with reduced levels of serum low-density lipoprotein cholesterol in adolescents. Data from the population-based German KiGGS study

Objectives: Attention-deficit/hyperactivity disorder (ADHD) is a multifactorial, complex and the most common neurodevelopmental disorder in childhood. In this analysis, we tested the hypothesis that altered serum lipid patterns are associated with ADHD.Methods: Using data from the nationwide, population-based German Health Interview and Examination Survey for Children and Adolescents (KiGGS), we compared serum levels of total cholesterol, high-density (HDL) and low-density lipoprotein (LDL) cholesterol, and also triglycerides, in participants with physician-diagnosed and/or suspected ADHD, as defined by a value of ≥7 on the hyperactivity-inattention subscale of the Strengths and Difficulties Questionnaire (SDQ), with non-ADHD controls.Results: Among 6,898 participants aged between 11 and 17 years, 666 (9.7%) had a physician-based diagnosis of ADHD and/or suspected ADHD. We found correlations between the parent-rated SDQ scores on the hyperactivity-inattention subscale and concentrations of triglycerides (r = 0.064, p < .001), total cholesterol (r = −0.026, p = .033), HDL cholesterol (r = −0.059, p < .001) and LDL cholesterol (r = −0.027, p = .031). In multivariate models, low serum levels of LDL cholesterol remained a significant predictor of ADHD (Exp(β) = 0.382, 95% confidence interval = 0.165−0.888, p = .025).Conclusions: Our findings in a large, nationwide and representative sample of German adolescents demonstrated a small, but significant and inverse link between LDL cholesterol levels and symptoms of ADHD. Further studies are required to decipher the biochemical mechanisms behind this relationship.

Associations between total mercury and methyl mercury exposure and cardiovascular risk factors in US adolescents.

Low levels of chronic heavy metal exposure are associated with a range of adverse health effects. However, whether total blood mercury (Hg) and methyl mercury (MeHg) exposure affect risk factors for cardiovascular disease (CVD) in adolescents remains unclear. The associations between CVD risk factors and total blood Hg and MeHg in adolescents were evaluated using data from the National Health and Nutrition Examination Survey (NHANES), 2011-2012. Data for 1129 adolescents (age 12-19years) who participated in the US NHANES 2011-2012 were analyzed. A multivariate linear regression was performed to investigate the associations between CVD risk factors and blood Hg and MeHg concentrations. We identified a strong positive association between blood Hg and MeHg and total cholesterol in adolescents in adjusted model. No associations with other CVD risk factors were found in the overall population. In the gender-stratified generalized linear models, girls with the highest MeHg levels demonstrated a 4.22% (95% CI 0.80%, 7.76%) greater increase in serum total cholesterol (P for trend = 0.029) when compared with girls with the lowest MeHg levels. Our findings suggest that blood MeHg may be positively associated with total cholesterol in adolescent girls. More research is needed to verify this association and to elucidate its underlying mechanisms.

Predictors of early adulthood hypertension during adolescence: a population-based cohort study

BackgroundSome longitudinal studies have shown that blood pressure tracks from adolescence to adulthood, yet there is limited evidence regarding the predictive factors of adulthood hypertension during adolescence. This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) to investigate the role of some factors in adolescence, measured in the first examination (1999–2001), to predict adulthood hypertension in the 4th examination (2009–2011).MethodsOverall, 1579 subjects, aged 10–19 years, were used for the analysis of the current study. Mean age (SD) of participants at the baseline was 14.2 (2.5) years and 55% of them were female. A forward stepwise approach (p-value <0.2 for enter and >0.05 for removal) was considered to keep significant covariates among common variables including gender, body mass index, waist circumference, wrist and hip circumferences, fasting blood sugar, triglycerides, high density lipoprotein cholesterol, total cholesterol (TC), systolic (SBP) and diastolic blood pressure (DBP). Variance inflation factor (VIF) showed some multicollinearity for anthropometric variables (VIFs between 3.5 and 10). Multivariable logistic regression revealed that gender, blood pressure, wrist circumference and total cholesterol in adolescents are important predictors for adulthood hypertension.ResultsThe risk increased by 4% and 39% per each 10 mmHg and 1 mmol/L increase in SBP/DBP and TC, respectively; additionally, females had a 70% lower risk. Among anthropometric variables, wrist circumference remained in the model, with 50% per centimeter increase in the risk of hypertension.ConclusionsWrist circumferences and TC had significant roles in predicting hypertension through adolescence to adulthood.

The Genetic Background of Metabolic Trait Clusters in Children and Adolescents.

It is well known that metabolic risk factors of cardiovascular diseases are correlated, but the background of this clustering in children is more poorly known than in adults. Thus, we studied the contribution of genetic and environmental factors to the clustering of metabolic traits in childhood and adolescence. Nine metabolic traits were measured in 214 complete twin pairs aged 3-18 years in the Autonomous Region of Madeira, Portugal, in 2007 and 2008. The variation of and covariations between the traits were decomposed into genetic and environmental components by using classical genetic twin modeling. A model, including additive genetic and environmental factors unique for each twin individual, explained the variation of metabolic factors well. Under this model, the heritability estimates varied from 0.47 (systolic blood pressure in children under 12 years of age) to 0.91 (high-density lipoprotein [HDL] cholesterol in adolescents 12 years of age or older). The most systematic correlations were found between adiposity (body mass index and waist circumference) and blood lipids (HDL cholesterol, low-density lipoprotein cholesterol, and triglycerides), as well as blood pressure. These correlations were mainly explained by common genetic factors. Our results suggest that obesity, in particular, is behind the clustering of metabolic factors in children and adolescents. Both general and abdominal obesity partly share the same genetic background as blood lipids and blood pressure. Obesity prevention early in childhood is important in reducing the risk of metabolic diseases in adulthood.

Abstract 17652: Application of Pediatric and Adult Lipid Treatment Guidelines to U.S. Adolescents Transitioning to Young Adulthood

Introduction: Current pediatric and adult lipid treatment guidelines differ in their approach to pharmacologic treatment of cholesterol in adolescents and young adults. We hypothesized that a greater proportion of young people ages 17-21 would meet criteria for statin treatment under the pediatric guidelines compared to adult guidelines, but that overall eligibility for statin treatment would be low in this age group. Methods: We applied treatment algorithms from the 2011 NHLBI Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents and the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults to participants in the 1999-2011 National Health and Nutrition Examination Surveys who were 17-21 years of age and had an LDL level measured (n=2,652). We extrapolated the results to a population of 11.2 million individuals ages 17-21 years living in the US. Results: Almost 2% of participants (n=50, 1.9%) qualified for statin treatment under the pediatric guidelines, but only 0.7% (n=18) met treatment criteria under the adult guidelines. Participants who met pediatric criteria had lower mean LDL levels but were more likely to have other cardiovascular risk factors, including hypertension, smoking, and obesity (Table 1). Despite the relatively low percentage of participants reaching LDL treatment thresholds under either guideline, 258,816 U.S. young people would be eligible for statin treatment under the pediatric guidelines and 84,651 would be eligible for treatment under the adult guidelines. Conclusions: Providers who care for adolescents transitioning to adulthood are faced with incongruent lipid guidelines. Application of pediatric guidelines, which use a life course approach and consider additional cardiovascular risk factors beyond age, may result in statin treatment for more young people.

Physical fitness, dietary intake, and metabolic control in adolescents with type 1 diabetes

We examined whether physical fitness and dietary intake predicted better glycemic control and lipid profile in adolescents with type 1 diabetes mellitus (T1DM). The sample consisted of 109 adolescents with T1DM [age, 15.3 +/- 1.9 yr; diabetes duration, 6.2 +/- 3.7 yr; body mass index (BMI), 23.3 +/- 4.0 kg/m(2); and hemoglobin A1c (HbA1c), 8.7 +/- 1.6%]. Stepwise regression analyses were performed with the following independent variables: age, sex, duration of diabetes, BMI, Tanner stage, physical fitness, and average carbohydrate and total and saturated fat intake, and the following dependent variables: total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides, and HbA1c. Physical fitness was measured by peak oxygen consumption (VO(2(peak))) during progressive cycle ergometry, and 3-day food intake was analyzed using Nutritionist Pro software. Sex and VO(2(peak)) explained 19% of the variance for HbA1c. Age, VO(2(peak)), and saturated fat intake predicted 23% of the variance for total cholesterol, although only diabetes duration and saturated fat intake predicted LDL-c (11%). Duration of diabetes explained 5% of the variance in triglyceride levels, and there were no significant independent predictors for HDL-c. Greater fitness levels predicted both better glycemic control and total cholesterol in adolescents with T1DM, whereas lower saturated fat affected total cholesterol but not glycemic control. These findings support the importance of physical fitness and diets of lower saturated fat for overall metabolic health in adolescents with T1DM.

Effect of leisure-time physical activity change on high-density lipoprotein cholesterol in adolescents and young adults.

In adults, the high-density lipoprotein cholesterol (HDL-C) level is higher among physically active subjects. However, the association of physical activity and HDL-C is less well studied in adolescents and young adults. Furthermore, it is not known whether the effect of physical activity on HDL-C levels is independent, or whether it is mediated by other physiological changes seen in exercise, such as weight loss or increased insulin sensitivity. In order to study the effects of leisure-time physical activity on the levels of serum HDL-C concentration, we analysed longitudinal data from a follow-up study of adolescents and young adults. The study subjects were participants of a large multicentre study of cardiovascular risk factors, aged 15-21 years at the beginning of the study (n = 714). HDL-C was measured from the serum supernatant after precipitation with dextran sulphate and MgCl2. A physical activity index was calculated on the basis of frequency, intensity, and duration of leisure-time activity assessed by a questionnaire. In males, an increase in the physical activity level predicted an increase in HDL-C concentration, and this association persisted after simultaneously controlling for changes in body mass index (kg/m2), subscapular skinfold thickness, serum insulin and triglyceride concentrations, and smoking. For example, an increase in the physical activity level corresponding to approximately 1 hour of intensive exercise weekly lead to an increase of 42 mumol/L in HDL-C as calculated from the regression equation. In conclusion, physical activity seems to have a direct effect on HDL-C levels among young male subjects within the usual range of physical activity levels.