A systematic review and meta-analysis on screening lipid disorders in the pediatric age group

Abstract

Background: Different viewpoints exist about lipid screening in all children or only in children with positive family history (FH)of premature cardiovascular diseases (CVDs) or hypercholesterolemia. This systematic review and meta-analysis aim to assess the effectiveness of lipid screening in children and adolescents according to the existence of positive FH of CVD risk factors.Materials and Methods: PubMed, Scopus, and Google  scholar were searched to identify relevant papers that were published from November 1980 until 30 November 2013. Irrelevant studies were set aside after studying their title, abstract, and full text. Then, the relevant studies were assessed by using a quality appraisal checklist. We used random effect  model for meta-analysis and calculating the total estimation of sensitivity, specificity, and the positive predictive value (PPV) of FH in predicting dyslipidemia among children and adolescents. Results: Overall, 17,214 studies were identified in the primary search, out of which 19 primary studies were qualified for study entry. The sensitivity of positive FH of premature CVD or  dyslipidemia for predicting dyslipidemia among children varied between 15 and 93. Moreover, the effectiveness of screening children for dyslipidemia according to premature CVD or  dyslipidemia in their relatives was low in 86.9% of the primary studies. The total estimation of sensitivity, specificity, and  predictive value was 42.6,59, and 20.7, respectively, according to the meta-analysis results. Conclusion: The present  meta-analysis indicated that selecting target population for  screening children and adolescents for dyslipidemia according to their FH has low sensitivity.

Key words: Children, family history (FH), lipid, meta-analysis, screening