PMC:4308887 / 2087-4821
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/4308887","sourcedb":"PMC","sourceid":"4308887","source_url":"http://www.ncbi.nlm.nih.gov/pmc/4308887","text":"Background\nCardiovascular disease is a leading cause of death in many countries, and epidemiological studies have linked this disease to elevations in serum lipids, such as total cholesterol (TC), non-high-density lipoprotein cholesterol (nHDL-c), low-density lipoprotein cholesterol (LDL-c) and triglycerides (TG), and a low concentration of high-density lipoprotein cholesterol (HDL-c); together, these changes contribute to the development of atherosclerosis [1-6]. The onset of this disease occurs during the first years of life, and coupled with the increased prevalence of dyslipidemia in the pediatric group, the evaluation of serum concentrations of these parameters at early ages is of utmost importance [5-9].\nThe definition of reference intervals (RIs) poses an arduous challenge for clinical laboratories worldwide, and the difficulties are even greater in the pediatric population [10-12]. Ideally, laboratories should define RIs based on their own populations [10]. This practice allows for accurate clinical interpretation and decision making. However, most laboratories adopt the values reported by the diagnostic test manufacturer or the medical literature [13,14]. Currently, a world task force involving several centers worldwide is striving to establish pediatric RIs [15-18].\nThe RIs for parameters such as serum lipids have been established using national and international consensuses that defined decision limits [10]. The decision limits specified in the medical literature are based on proposals of the National Cholesterol Education Program (NCEP) in 1992 and were updated by the National Heart, Lung and Blood Institute (NHLBI) in 2012 [1,5]. These guidelines are based on studies conducted over more than 3 decades. There are three guidelines on lipids and lipoprotein for children and adolescents in Brazil, including the 1st Brazilian Guideline for the Prevention of Atherosclerosis in Childhood and Adolescence [19], the 5th Brazilian Guideline on Dyslipidemia and the Prevention of Atherosclerosis [20] and the 1st Brazilian Guideline on Familial Hypercholesterolemia [21]. However, these guidelines use the RIs, not for their own population, but for American children and adolescents. This fact can lead to misinterpretation because demographic characteristics and variables, such as diet and geographic regions, may interfere with these parameters [1,5,10]. Therefore, lipid parameters for the local population determined by local studies with well-defined protocols are essential for the correct interpretation of laboratory tests and clinical decision making. This study determined the RIs for TC, HDL-c, n-HDLc, LDL-c and TG in healthy children and adolescents from Cuiabá City in Midwest 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