Evaluating the prevalence of lipid assessments in children in Alberta, Canada.

CMAJ open Pub Date : 2023-09-19 Print Date: 2023-09-01 DOI:10.9778/cmajo.20220163
Susan Christian, Ross Ridsdale, Mu Lin, Michael Khoury
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引用次数: 0

Abstract

Background: Familial hypercholesterolemia is a common, inherited, life-threatening and treatable condition that is characterized by marked elevations of low-density lipoprotein cholesterol (LDL-C), resulting in a high risk of cardiovascular disease, but treatment starting in childhood dramatically reduces this risk. We sought to evaluate the prevalence of pediatric lipid assessments among children in Alberta.

Methods: We reviewed laboratory and administrative data from Alberta Health between Apr. 1, 2012, and Dec. 31, 2021. We evaluated 2 pediatric cohorts (children aged 2-10 yr and children aged 9-17 yr) to allow for longitudinal assessments throughout the pediatric period. We also reviewed annual frequencies of lipid assessment for all children between 2013 and 2021.

Results: Pediatric lipid assessments were performed for 1972 (4.3%) of 46 170 children aged 2-10 years and for 8158 (19.9%) of 40 926 children aged 9-17 years. Female children (aged 2-10 yr) and those living in rural communities were significantly less likely to have a lipid assessment, compared with male children and those in nonrural communities. Among those with lipid assessments, 23 (1.2%) and 86 (1.1%) children aged 2-10 years and 9-17 years, respectively, had an LDL-C level suggestive of probable familial hypercholesterolemia (≥ 4.0 mmol/L). Statin therapy was prescribed in 16 children during the study period. The frequency of lipid assessments was relatively stable, with the exception of a decrease in 2020.

Interpretation: Rates of pediatric lipid assessment in Alberta are suboptimal. These findings highlight the need to increase awareness of the benefits of early diagnosis and treatment of familial hypercholesterolemia with regard to long-term health and identify and overcome barriers to diagnosis and treatment.

Abstract Image

Abstract Image

评估加拿大艾伯塔省儿童脂质评估的流行率。
背景:家族性高胆固醇血症是一种常见的、遗传的、危及生命的、可治疗的疾病,其特征是低密度脂蛋白胆固醇(LDL-C)显著升高,导致心血管疾病的高风险,但从儿童时期开始的治疗可显着降低这种风险。我们试图评估阿尔伯塔省儿童儿童脂质评估的流行率。方法:我们回顾了2012年4月1日至2021年12月31日期间阿尔伯塔省卫生局的实验室和管理数据。我们评估了2个儿科队列(2-10岁的儿童和9-17岁的儿童),以便在整个儿科时期进行纵向评估。我们还回顾了2013年至2021年间所有儿童的年度脂质评估频率。结果:在46170名2-10岁儿童中,1972人(4.3%)进行了儿科脂质评估,在40926名9-17岁儿童中进行了8158人(19.9%)的儿科脂质评估。与男性儿童和非农村社区儿童相比,女性儿童(2-10岁)和农村社区儿童进行脂质评估的可能性显著降低。在进行脂质评估的儿童中,23名(1.2%)和86名(1.1%)2-10岁和9-17岁的儿童LDL-C水平提示可能存在家族性高胆固醇血症(≥4.0 mmol/L)。在研究期间,16名儿童接受了他汀类药物治疗。脂质评估的频率相对稳定,但2020年有所下降。解释:阿尔伯塔省的儿童脂质评估率次优。这些发现突出表明,需要提高对家族性高胆固醇血症早期诊断和治疗对长期健康的益处的认识,并识别和克服诊断和治疗的障碍。
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CiteScore
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