title: Lipid screening in children and adolescents in community practice: 2007 to 2010.
abstract: BACKGROUND
  Integrated guidelines on cardiovascular health and risk reduction in children issued in 2011 newly recommended universal screening for dyslipidemia in children at 9 to 11 years and 17 to 21 years.
  
  
  RESULTS
  We determined the frequency and results of lipid testing in 301 080 children and adolescents aged 3 to 19 enrolled in 3 large US health systems in 2007 to 2010 before the 2011 guidelines were issued. Overall, 9.8% of the study population was tested for lipids. The proportion tested varied by body mass index percentile (5.9% of normal weight, 10.8% of overweight, and 26.9% of obese children) and age (8.9% of 9- to 11-year olds and 24.3% of 17- to 19-year olds). In normal weight individuals, 2.8% of 9- to 11-year olds and 22.0% of 17- to 19-year olds were tested. In multivariable models, age and body mass index category remained strongly associated with lipid testing. Sex, race, ethnicity, and blood pressure were weakly associated with testing. Abnormal lipid levels were found in 8.6% for total cholesterol, 22.5% for high-density lipoprotein-cholesterol, 12.0% for non-high-density lipoprotein-cholesterol, 8.0% for low-density lipoprotein-cholesterol, and 21% for triglycerides (age, 10-19 years). There was a strong and graded association of abnormal lipid levels with body mass index, particularly for high-density lipoprotein-cholesterol and triglycerides (2- to 6-fold higher odds ratio in obese when compared with that in normal weight children).
  
  
  CONCLUSIONS
  Lipid screening was uncommon in 9- to 11-year olds and was performed in a minority of 17- to 19-year olds during 2007 to 2010. These data serve as a benchmark for assessing change in practice patterns after the new recommendations for pediatric lipid screening and management.
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.). Karen.l.margolis@healthpartners.com.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Margolis
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Louise C
authors.initials: LC
authors.lastname: Greenspan
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Nicole K
authors.initials: NK
authors.lastname: Trower
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Daley
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Daniels
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Joan C
authors.initials: JC
authors.lastname: Lo
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Elyse O
authors.initials: EO
authors.lastname: Kharbanda
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Alan R
authors.initials: AR
authors.lastname: Sinaiko
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: David J
authors.initials: DJ
authors.lastname: Magid
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Emily D
authors.initials: ED
authors.lastname: Parker
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Malini
authors.initials: M
authors.lastname: Chandra
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Heather M
authors.initials: HM
authors.lastname: Tavel
authors.affiliation: From the HealthPartners Institute for Education and Research, Minneapolis, MN (K.L.M., N.K.T., E.O.K., E.D.P., P.J.O.); Department of Pediatrics, Kaiser Permanente San Francisco, CA (L.C.G.); Department of Pediatrics, University of Colorado School of Medicine, Aurora, (M.F.D., S.R.D.); Institute for Health Research, Kaiser Permanente Colorado, Denver (M.F.D., D.J.M., H.M.T.); Department of Pediatrics, University of Minnesota, Minneapolis (A.R.S.); and Division of Research, Kaiser Permanente Northern California, Oakland (J.C.L., M.C.).
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: O'Connor
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D050171:Dyslipidemias / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012946:Social Welfare / Q000706:statistics & numerical data*; D014280:Triglycerides / Q000097:blood; D014481:United States; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: adolescent; child; cholesterol; diagnosis; dyslipidemias; electronic health records