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(Circulation. 2006;114:1056-1062.)
© 2006 American Heart Association, Inc.

Pediatric Cardiology

Distribution of Lipoproteins by Age and Gender in Adolescents

Courtney J. Jolliffe, MSc; Ian Janssen, PhD

From the School of Kinesiology and Health Studies (C.J.J., I.J.) and Department of Community Health and Epidemiology (I.J.), Queen’s University, Kingston, Ontario, Canada.

Reprint requests to Ian Janssen, PhD, School of Kinesiology and Health Studies, Queen’s University, 69 Union St, Kingston, Ontario, Canada, K7L 3N6. E-mail janssen{at}post.queensu.ca

Received February 13, 2006; revision received June 13, 2006; accepted June 23, 2006.

Background— The current National Cholesterol Education Program lipoprotein classification system for children and adolescents is recommended for use among 2- to 19-year-olds. This classification system does not take into account gender differences or the natural fluctuations in lipoprotein concentrations that occur with growth and maturation.

Methods and Results— Data from the National Health and Nutrition Examination Surveys were used to develop age- and gender-specific thresholds that can be used to denote abnormal levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. Each curve was linked to the adult National Cholesterol Education Program Adult Treatment Panel III lipoprotein thresholds using LMS (Lambda-Mu-Sigma) growth curve regression methods. A series of growth curves and tables are presented that can be used to diagnose high-risk lipoprotein levels in the clinical and research settings. For example, in 1-year increments for males starting at age 12 and extending to age 19 years, the high-risk thresholds for total cholesterol were 6.03, 5.83, 5.70, 5.70, 5.77, 5.88, 6.02, and 6.16 mmol/L. The corresponding high-risk threshold for adults (20 years) is 6.22 mmol/L.

Conclusions— The present study is the first attempt at developing age- and gender-specific lipoprotein threshold concentrations for adolescents. This new classification system should provide a more accurate diagnosis of high-risk lipoprotein levels and associated cardiovascular risks in adolescents.

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