Abstract：
OBJECTIVE: The utility of lipid screening in pediatric settings for preventing adult atherosclerotic cardiovascular diseases partly depends on the lifelong tracking of lipid levels. This systematic review aimed to quantify the tracking of lipid levels from childhood and adolescence to adulthood.
METHODS: We systematically searched MEDLINE, Embase, Web of Science, and Google Scholar in March 2022. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO; ID: CRD42020208859). We included cohort studies that measured tracking of lipids from childhood or adolescence (<18 years) to adulthood (≥18) with correlation or tracking coefficients. We estimated pooled correlation and tracking coefficients using random-effects meta-analysis. Risk of bias was assessed with a review-specific tool.
RESULTS: Thirty-three studies of 19 cohorts (11,020 participants) were included. The degree of tracking from childhood and adolescence to adulthood differed among lipids. Tracking was observed for low-density lipoprotein cholesterol (pooled r = 0.55-0.65), total cholesterol (pooled r = 0.51-0.65), high-density lipoprotein cholesterol (pooled r = 0.46-0.57), and triglycerides (pooled r = 0.32-0.40). Only one study included tracking of non-high-density lipoprotein cholesterol (r = 0.42-0.59). Substantial heterogeneity was observed. Study risk of bias was moderate, mostly due to insufficient reporting and singular measurements at baseline and follow-up.
CONCLUSIONS: Early-life lipid measurements are important for predicting adult levels. However, further research is needed to understand the tracking of non-high-density lipoprotein cholesterol and the stability of risk classification over time, which may further inform pediatric lipid screening and assessment strategies.
METHODS: We systematically searched MEDLINE, Embase, Web of Science, and Google Scholar in March 2022. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO; ID: CRD42020208859). We included cohort studies that measured tracking of lipids from childhood or adolescence (<18 years) to adulthood (≥18) with correlation or tracking coefficients. We estimated pooled correlation and tracking coefficients using random-effects meta-analysis. Risk of bias was assessed with a review-specific tool.
RESULTS: Thirty-three studies of 19 cohorts (11,020 participants) were included. The degree of tracking from childhood and adolescence to adulthood differed among lipids. Tracking was observed for low-density lipoprotein cholesterol (pooled r = 0.55-0.65), total cholesterol (pooled r = 0.51-0.65), high-density lipoprotein cholesterol (pooled r = 0.46-0.57), and triglycerides (pooled r = 0.32-0.40). Only one study included tracking of non-high-density lipoprotein cholesterol (r = 0.42-0.59). Substantial heterogeneity was observed. Study risk of bias was moderate, mostly due to insufficient reporting and singular measurements at baseline and follow-up.
CONCLUSIONS: Early-life lipid measurements are important for predicting adult levels. However, further research is needed to understand the tracking of non-high-density lipoprotein cholesterol and the stability of risk classification over time, which may further inform pediatric lipid screening and assessment strategies.
摘要：
目的：血脂筛查在儿科预防成人动脉粥样硬化性心血管疾病中的效用部分取决于对血脂水平的终身追踪。这项系统评价旨在量化从儿童和青春期到成年期的脂质水平跟踪。
方法：我们系统地搜索了MEDLINE，Embase,WebofScience,和谷歌学者在2022年3月。该方案已在国际前瞻性系统审查注册中心（PROSPERO；ID：CRD42020208859）注册。我们纳入了队列研究，这些研究测量了从儿童或青春期（<18岁）到成年期（≥18岁）的血脂追踪，并具有相关性或追踪系数。我们使用随机效应荟萃分析估计了混合相关性和跟踪系数。使用特定的审查工具评估偏倚风险。
结果：纳入了19个队列（11,020名参与者）的33项研究。从儿童和青春期到成年期的追踪程度在脂质之间有所不同。追踪观察到低密度脂蛋白胆固醇（合并r=0.55-0.65），总胆固醇（合并r=0.51-0.65），高密度脂蛋白胆固醇（合并r=0.46-0.57），和甘油三酯（合并r=0.32-0.40）。只有一项研究包括非高密度脂蛋白胆固醇的追踪（r=0.42-0.59）。观察到实质性的异质性。偏倚的研究风险中等，主要是由于基线和随访时的报告不足和单一测量结果。
结论：早期血脂测量对于预测成人水平很重要。然而,需要进一步的研究来了解非高密度脂蛋白胆固醇的跟踪和风险分类随时间的稳定性，这可能进一步为儿科脂质筛查和评估策略提供信息。
方法：我们系统地搜索了MEDLINE，Embase,WebofScience,和谷歌学者在2022年3月。该方案已在国际前瞻性系统审查注册中心（PROSPERO；ID：CRD42020208859）注册。我们纳入了队列研究，这些研究测量了从儿童或青春期（<18岁）到成年期（≥18岁）的血脂追踪，并具有相关性或追踪系数。我们使用随机效应荟萃分析估计了混合相关性和跟踪系数。使用特定的审查工具评估偏倚风险。
结果：纳入了19个队列（11,020名参与者）的33项研究。从儿童和青春期到成年期的追踪程度在脂质之间有所不同。追踪观察到低密度脂蛋白胆固醇（合并r=0.55-0.65），总胆固醇（合并r=0.51-0.65），高密度脂蛋白胆固醇（合并r=0.46-0.57），和甘油三酯（合并r=0.32-0.40）。只有一项研究包括非高密度脂蛋白胆固醇的追踪（r=0.42-0.59）。观察到实质性的异质性。偏倚的研究风险中等，主要是由于基线和随访时的报告不足和单一测量结果。
结论：早期血脂测量对于预测成人水平很重要。然而,需要进一步的研究来了解非高密度脂蛋白胆固醇的跟踪和风险分类随时间的稳定性，这可能进一步为儿科脂质筛查和评估策略提供信息。
