Is family history of premature cardiovascular diseases appropriate for detection of dyslipidemic children in population-based preventive medicine programs? CASPIAN study.

The objectives of this study were to determine the prevalence of dyslipidemia and the usefulness of self-report family history (FH) of premature cardiovascular disease (CVD) for identifying children with lipid disorders. This study was conducted on a representative, population-based sample of 4811 Iranian children and adolescents (2248 boys and 2563 girls) aged 6-18 years. We compared the obtained serum lipid profile with that of the Lipid Research Clinic (LRC) and calculated the predictive value of FH for detecting those children with dyslipidemia.Overall, for both genders and for age groups, the mean serum triglycerides (TG) and its percentiles were significantly higher, and the mean and percentiles of total, low-density, and high-density cholesterol (TC, LDL-C, and HDL-C respectively) were significantly lower than the LRC values. In total, 45.7% of participants had dyslipidemia; the most frequent ones were low HDL-C (24.8%) and hypertriglyceridemia (24.5%), followed by hypercholesterolemia (6.4%) and high LDL-C (6.3%), respectively. The mean serum lipid levels and the anthropometric measures were not significantly different among those with or without positive FH. The sensitivity, and specificity, positive and negative predictive values for FH in detecting those children with dyslipidemia were 28.4, 70.3. 44.7, and 53.8%, respectively. The usefulness of FH in identifying dyslipidemic children was relatively low. The common lipid disorders in our community were the components of the metabolic syndrome. We suggest that the current guidelines for screening lipid disorders in youths, which are based on cholesterol, should consider such ethnic differences.