title: Combined dyslipidemia in obese children: response to a focused lifestyle approach.
abstract: BACKGROUND
  Combined dyslipidemia (elevated triglyceride [TG] ± non-high-density lipoprotein cholesterol [non-HDL-C] ± total cholesterol [TC] ± low-density lipoprotein cholesterol [LDL-C] ± reduced high-density lipoprotein cholesterol [HDL-C]) is seen in >40% of obese children. Primary recommended treatment is weight loss with limited reports of any other approach.
  
  
  OBJECTIVE
  In children with combined dyslipidemia, evaluate the response to a clinical protocol focused on diet composition change and increased activity with no direct weight loss approach.
  
  
  METHODS
  Retrospective review of lipid profile and growth parameter changes in patients 6 to 18 years of age with diagnosis of combined dyslipidemia seen between December 31, 2009, and December 31, 2011, managed with this protocol through 2 follow-up visits. Combined dyslipidemia diagnosed when ≥2 lipid values exceed the upper limit of normal for TC, TG, non-HDL-C, or LDL-C ± HDL-C below the lower limit of normal.
  
  
  RESULTS
  Fifty-three patients were identified, 55% male, 92% obese, mean age 12.1 ± 3.4 years with mean follow-up 9.2 months. Lipid parameters (mean ± SD, mg/dL) improved significantly (P < .001): TC 209 ± 39 to 181 ± 32; TG 255 ± 119 to168 ± 99; non-HDL-C 167 ± 35 to 138 ± 30 and LDL-C 121 ± 43 to 106 ± 30. HDL-C was unchanged. Body mass index decreased in 58% and mean body mass index decreased 0.67 kg/m(2) (P < .05).
  
  
  CONCLUSIONS
  Focused lifestyle changes significantly improved combined dyslipidemia in obese children. With no direct weight loss approach, body mass index decreased in 58%.
authors.affiliation: University of Rochester Medical Center, 601 Elmwood Avenue, Box 631, Rochester, NY 14642. Electronic address: rprattmd@gmail.com.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Pratt
authors.affiliation: University of Rochester Medical Center, 601 Elmwood Avenue, Box 631, Rochester, NY 14642.
authors.forename: Rae-Ellen
authors.initials: RE
authors.lastname: Kavey
authors.affiliation: University of Rochester Medical Center, 601 Elmwood Avenue, Box 631, Rochester, NY 14642.
authors.forename: Donna
authors.initials: D
authors.lastname: Quinzi
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000235:genetics; D008019:Life Style; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss
chemical_list: D008078:Cholesterol, LDL; C034396:HDL-triglyceride; D008075:Lipoproteins, HDL; D014280:Triglycerides
keywords: Dyslipidemia; Hyperlipidemia; Hypertriglyceridemia; Obesity; Pediatric