Primary hyperlipidemia in a pediatric population: classification and effect of dietary treatment.
Patients seen at a pediatric lipid clinic over a 27-month period were reviewed retrospectively to evaluate types of primary lipid disorders and effect of dietary treatment at the first follow-up visit. One hundred eighty-two patients were classified into one of four categories: (1) elevated low-density lipoprotein cholesterol (LDL-C) with LDL-C > 95th percentile (32%); (2) isolated triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) abnormalities, with TG > 95th percentile and/or HDL-C < 5th percentile (30%); (3) borderline LDL-C, TG, or HDL-C (29%); (4) normal (9%). The American Heart Association Step-One Diet was prescribed for all patients older than 2 years, and they received extensive nutritional and risk-management counseling. Of these patients, 59 (32%) returned for at least one follow-up visit and mean changes in lipid values between initial and first follow-up visits were evaluated. Levels of LDL-C decreased by 24 mg/dL in 22 patients with elevated LDL-C levels. Triglyceride levels decreased by a mean of 22 mg/dL and HDL-C increased by a mean of 4 mg/dL in 21 patients with isolated TG/HDL-C abnormalities. Levels of LDL-C tended to rise in this group, but not to a significant degree. A new finding of this report is that screening for total cholesterol results in the identification of many children with TG or HDL-C abnormalities alone and that the Step-One Diet appears to be effective in improving both TG and HDL-C levels in these patients.
Polonsky
S M
SM
Dept of Pediatrics, Children's Hospital Medical Center, Cincinnati, OH 45229-2899.
Bellet
P S
PS
Sprecher
D L
DL
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003376:Counseling / Q000592:standards; D004041:Dietary Fats / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000592:standards; D006776:Hospitals, Pediatric; D006801:Humans; D006949:Hyperlipidemias / Q000145:classification / Q000178:diet therapy / Q000453:epidemiology*; D007223:Infant; D008297:Male; D008403:Mass Screening; D052756:Nutritional Sciences / Q000193:education; D009820:Ohio / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004041:Dietary Fats; D014280:Triglycerides