Prevalence of Familial Hypercholesterolemia in the 1999 to 2012 United States National Health and Nutrition Examination Surveys (NHANES)
Prevalence of Familial Hypercholesterolemia in the 1999 to 2012 United States National Health and Nutrition Examination Surveys (NHANES)
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DOI：
10.1161/circulationaha.115.018791
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发表时间：
2016-03-15
期刊：
影响因子：
37.8
通讯作者：
Sheldrick, R. Christopher
中科院分区：
文献类型：
--
作者：
de Ferranti, Sarah D.;Rodday, Angie Mae;Sheldrick, R. Christopher
背景家族性高胆固醇血症（FH）的患病率通常报道为1/500。欧洲的报告表明，发病率较高;方法和结果1999年至2012年国家健康与营养调查（NHANES）参与者年龄20岁，（n=36 949）进行了分析，以估计FH的患病率与可用的荷兰脂质诊所标准，包括低密度脂蛋白胆固醇和过早动脉粥样硬化性心血管疾病的个人和家族史。根据年龄、性别、肥胖状态（体重指数30 kg/m2）和人种/种族计算总体人群中可能/明确FH的患病率和置信区间。结果外推到2.1亿20岁的美国成年人。估计的美国可能/明确FH的总体患病率为0.40%（95%置信区间，0.32-0.48）或1/250（95%置信区间，1/311 - 209），表明834500名美国成人患有FH。患病率因年龄而异，在20至29奥尔兹中最不常见（0.06%，1/1557），在60至69奥尔兹中最常见（0.85%，1/118）。男性和女性的FH患病率相似（0.40%，1/250），但因人种/种族而异（白人：0.40%，1/249;黑人：0.47%，1/211;墨西哥裔美国人：0.24%，1/414;其他人种：0.29%，1/343）。更多的肥胖参与者合格的可能/明确FH（0.58%，1在172）比非肥胖（0.31%，1在325）。结论FH，定义与荷兰脂质诊所标准在NHANES，影响1在250美国成年人。不同年龄和肥胖状态的患病率差异表明，临床标准可能不足以估计FH患病率。
Background The prevalence of familial hypercholesterolemia (FH) is commonly reported as 1 in 500. European reports suggest a higher prevalence; the US FH prevalence is unknown.Methods and Results The 1999 to 2012 National Health and Nutrition Examination Survey (NHANES) participants 20 years of age (n=36 949) were analyzed to estimate the prevalence of FH with available Dutch Lipid Clinic criteria, including low-density lipoprotein cholesterol and personal and family history of premature atherosclerotic cardiovascular disease. Prevalence and confidence intervals of probable/definite FH were calculated for the overall population and by age, sex, obesity status (body mass index 30 kg/m(2)), and race/ethnicity. Results were extrapolated to the 210 million US adults 20 years of age. The estimated overall US prevalence of probable/definite FH was 0.40% (95% confidence interval, 0.32-0.48) or 1 in 250 (95% confidence interval, 1 in 311 to 209), suggesting that 834 500 US adults have FH. Prevalence varied by age, being least common in 20 to 29 year olds (0.06%, 1 in 1557) and most common in 60 to 69 year olds (0.85%, 1 in 118). FH prevalence was similar in men and women (0.40%, 1 in 250) but varied by race/ethnicity (whites: 0.40%, 1 in 249; blacks: 0.47%, 1 in 211; Mexican Americans: 0.24%, 1 in 414; other races: 0.29%, 1 in 343). More obese participants qualified as probable/definite FH (0.58%, 1 in 172) than nonobese (0.31%, 1 in 325).Conclusions FH, defined with Dutch Lipid Clinic criteria available in NHANES, affects 1 in 250 US adults. Variations in prevalence by age and obesity status suggest that clinical criteria may not be sufficient to estimate FH prevalence.