Trends in levels of lipids and apolipoprotein B were favorable for US youths from 1999 to 2016, according to results from a study published in JAMA.

Investigators conducted a serial cross-sectional analysis using population-weighted data to assess trends in lipid and apolipoprotein B levels in individuals aged 6 to 19 years.

Outcomes measured included age- and race/ethnicity-adjusted average levels of high-density lipoprotein (HDL), non-HDL, and total cholesterol. Averaged levels of low-density lipoprotein cholesterol (LDL-C), geometric mean levels of triglycerides, and average apolipoprotein B levels were outcomes measured in fasting adolescents aged 12 to 19 years. Prevalence of ideal and adverse levels of lipids and apolipoprotein B per pediatric lipid guideline were also measured outcomes.

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A total of 26,047 individuals (weighted average age, 12.4 years; 51% girls) were included in the study. Compared with results from 1999 to 2000, adjusted average total cholesterol levels decreased from 2015 to 2016 (164 mg/dL vs 155 mg/dL, respectively).

Compared with 2007 to 2008 results, 2015 to 2016 saw an increase in adjusted average HDL cholesterol levels (52.5 mg/dL vs 55.0 mg/dL, respectively), whereas non-HDL cholesterol decreased during the same time (108 mg/dL vs 100 mg/dL).

For fasting adolescents, geometric mean levels of triglycerides and mean levels of LDL-C decreased from 1999-2000 to 2013-2014. Average levels of apolipoprotein B also decreased, and investigators noticed that 51.4% of the population had ideal levels of HDL, non-HDL, and total cholesterol by the end of the analysis, and 46.8% of adolescents had ideal lipid and apolipoprotein B levels.

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Adverse levels of lipids and apolipoprotein B were reported in 15.2% of children aged 6 to 11 years, and in 25.2% of adolescents aged 12 to 19 years.

“It will be important to understand the reasons for the favorable lipid trends observed in this study to both acknowledge public health successes and plan future efforts,” the investigators noted. “A wide variety of factors has been associated with lipid and apolipoprotein B levels…. Among US youths, some of these factors may be improving (eg, decreased trans fats in the food supply), others are worsening (eg, [body mass index]), and others may be changing in unknown ways.”

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Perak AM, Ning H, Kit BK, et al. Trends in levels of lipids and apolipoprotein B in US youths aged 6 to 19 years, 1999-2016. JAMA. 2019;321(19):1895-1905.