日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Pediatric Cardiology and Cardiac Surgery 35(2): 112-118 (2019)
doi:10.9794/jspccs.35.112

原著Original

Non-HDLコレステロール値からみた家族性高コレステロール血症児頻度の考察Evaluation of Familial Hypercholesterolemia Prevalence in Children Using Non-High-Density Lipoprotein Cholesterol Levels

1JCHO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

受付日:2018年9月19日Received: September 19, 2018
受理日:2019年1月18日Accepted: January 18, 2019
発行日:2019年5月1日Published: May 1, 2019
HTMLPDFEPUB3

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

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。