Regional experience with universal screening for total cholesterol in children
D.I. Sadykova, A.A. Kamalova, R.F. Rakhmaeva, T.P. Makarova, Yu.S. Melnikova, L.F. Galimova, E.S. Slastnikova, A.A. Mustafaeva, M.A. Petrova, A.A. Garipova, Yu.A. Kalistratova, A.V. Shtyrkova, S.А. Sеnеk
1) Kazan State Medical University, Kazan, Russia;
2) Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan, Russia
Background. The prevalence of risk factors for cardiovascular disease (CVD) is rapidly increasing. The world has accumulated clinical experience in screening for the detection of lipid metabolism disorders, but such studies have not been conducted in children in Russia.
Objective. Determination of the risk groups for the development of CVD among children based on the assessment of the hereditary factor, the level of physical development and blood total cholesterol (TC).
Methods. A cross-sectional study was conducted in 542 children aged 10 years (49% of boys and 51% of girls), and included signing of informed consent, questionnaires, study of child’s record, anthropometry with WHO AnthroPlus assessment, blood pressure measurement, determination of TC level by MultiCare-in express method (Italy).
Results. According to the survey data, risk factors included the presence in second-line relatives: myocardial infarction – in 15% of children, stroke – in 19%, arterial hypertension – in 40%, excess body weight – in 24%, diabetes mellitus – in 22%, vascular surgery heart and head - in 9%, smoking – in 63%. Nutritional disorders were revealed in 48% of children: underweight in 21% of children, overweight in 17%, obesity in 10%. In 35% of children, an increased TC level was determined. A high TC level was detected both in children with underweight and in children with overweight and obesity. In 7% of children (n=38), systolic blood pressure was above the 90% percentile.
Conclusion. Risk groups for the development of CVD were identified, including children with an elevated TC level, systolic blood pressure above the 90% percentile, and nutritional status disorders. A high TC level in children with normal physical development dictates the need for a more detailed assessment of the nutritional status with the determination of the component composition of the body. Children with a capillary TC level of more than 5.2 mmol/L should be examined for TC in venous blood; and a differential diagnosis of primary and secondary genesis of dyslipidemia should be made.
About the Autors
Corresponding author: Aelita A. Kamalova, Dr. Sci. (Med.), Professor, Department of Hospital Pediatrics, Kazan State Medical University, Physician, Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan, Russia; firstname.lastname@example.org