1 JCHO高岡ふしき病院小児科JCHO Takaoka-Fushiki Hospital, Department of Pediatrics ◇ Toyama, Japan
2 高岡市医師会Takaoka City Medical Association ◇ Toyoma, Japan
背景：幼少期から動脈硬化が進行する家族性高コレステロール血症（FH）に関し，小児生活習慣病予防健診結果から小児の頻度を考察する．
方法：2006～2015年度の10年間に高岡市健診を受診した小4児14,609名（男7,461名，女7,148名）を対象に，non-HDLコレステロール（non-HDL-C）値の分布から超高値児を抽出し，小児FHの頻度との関連を考察した．
結果：対象のnon-HDL-Cと肥満度とは弱く相関した（r＝0.30）が，散布図上概ね200 mg/dL以上に関連の弱い超高値児が散在し，その多くがFHと推察された．Non-HDL-C 200 mg/dLはほぼ＋4SD値，かつガイドライン上の小児FH治療閾値に相当した．10年間でnon-HDL-C 130 mg/dL以上の高値児割合は減少したが，超高値児割合には有意な変化なく，全体での0.38％は小児の要治療FH頻度に近似する値と考えられた．
結論：Non-HDL-C測定は小児要治療FH抽出に有用である可能性が示唆され，その頻度は日本成人FHの推定頻度とも矛盾しない．
Background: Atherosclerosis may gradually progress, even during infancy, in patients with familial hypercholesterolemia (FH). We evaluated FH prevalence in schoolchildren using the results of a screening program for preventing lifestyle-related disease.
Methods: In total, 14,609 (7,461 boys and 7,148 girls) 4th grade schoolchildren were examined during the screening program in Takaoka city from 2006 to 2015. The distribution of the serum non-HDL-cholesterol (non-HDL-C) levels and the prevalence of extremely high non-HDL-C values were used to determine childhood FH prevalence.
Results: There was only a weak correlation between the percentage of overweight (POW) and serum non-HDL-C levels (r＝0.30). Since extremely high non-HDL-C levels (＞200 mg/dL) did not correlate with POW, many of these children were suspected of having FH. Non-HDL-C level 200 mg/dL was almost equivalent to 4 standard deviations above the mean, and is the current recommended treatment threshold for children with FH according to Japanese guidelines. Although the prevalence of high non-HDL-C subjects (≥130 mg/dL) decreased over the course of the 10-year study, the prevalence of extremely high levels (≥200 mg/dL) did not changed. The overall prevalence of children with extremely high non-HDL-C levels was 0.38％, which was considered close to the prevalence of treatment recommended FH in children.
Conclusion: Non-HDL-C levels may be useful for identifying children with FH who would benefit from treatment. In Japan, FH prevalence in children is similar to that estimated in adults.
Key words: familial hypercholesterolemia; non-high-density lipoprotein cholesterol; cardiovascular risk factor; children; universal screening
© 2019 特定非営利活動法人日本小児循環器学会© 2019 Japanese Society of Pediatric Cardiology and Cardiac Surgery
This page was created on 2019-04-09T17:16:12.115+09:00
This page was last modified on 2019-05-17T15:31:52.000+09:00
このサイトは（株）国際文献社によって運用されています。
