Should We Test Teens for High Cholesterol?

Not surprisingly, overweight and obese youths were much more likely than those of normal weight to have unhealthy cholesterol and triglyceride levels. Some 43 percent of obese adolescents had at least one abnormality, as did 22 percent of those considered overweight for their age and height. By comparison, only 14.2 percent of normal-weight participants had abnormal levels.

An unsigned commentary by MMWR's editors noted that "untreated abnormal lipid levels in childhood and adolescence are linked to increased risk for cardiovascular disease in adulthood," but they stopped short of endorsing routine lipid testing for adolescents.

The AAP recommends screening youths with specific risk factors such as being overweight and family history of high cholesterol and triglyceride levels. The U.S. Preventive Services Task Force looked at the screening issue in 2007 and decided not to recommend for or against routine screening.

The MMWR editors suggested a strategy in line with the pediatrics group's recommendation. "Targeted screening of youths for abnormal lipid levels can identify those youths who might benefit from interventions that reduce the risk for [cardiovascular disease]," they wrote.

"Based on the findings in this study, clinicians should be aware of lipid screening guidelines and recommended interventions for children and youths who are overweight or obese," the editors added.

Such interventions include behavior and nutrition counseling and, if levels remain abnormal, drug treatment.

But the editors pointed out that fewer than 1 percent of NHANES participants included in the current study "had [cholesterol and/or triglyceride] levels high enough to warrant drug therapy according to AAP guidelines."

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