ABC | Volume 114, Nº1, January 2019

Original Article Evaluation of Lipid Profiles of Children and Youth from Basic Health Units in Campinas, SP, Brazil: A Cross‑Sectional Laboratory Study Érica Ivana Lázaro Gomes, 1 Vanessa Helena de Souza Zago, 2 Eliana Cotta de Faria 1 Universidade Estadual de Campinas - Patologia Clínica, 1 Campinas, SP – Brazil Pontifícia Universidade Católica de Campinas (PUC - Campinas), 2 Campinas, SP – Brazil MailingAddress: Eliana Cotta de Faria • Universidade Estadual de Campinas - Patologia Clínica - Rua Tessália Vieira de Camargo, 126. Postal Code 13083-887, Cidade Universitária Zeferino Vaz Campinas, SP – Brazil E-mail: cottadefaria@gmail.com Manuscript received June 29, 2018, revised manuscript February 12, 2019, accepted March 10, 2019 DOI: 10.5935/abc.20190209 Abstract Background: Among dyslipidemias, hypercholesterolemia is considered the main risk factor for cardiovascular diseases in adults. In childhood and adolescence, elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) are positively associated with atherosclerosis markers, however, systematic screening for dyslipidemias in these groups is a controversial topic. Objective: To characterize the frequencies, types and severity of dyslipidemias in children and adolescents attended at the Basic Health Units managed by SUS in Campinas/SP. Methods: After an agreement with the Municipal Health Department of Campinas, consecutive results of serum lipid profiles (n = 312,650) of individuals of both sexes (n = 62,530) aged between 1 day old and 19 years were obtained, from 2008 to 2015. Age groups and dyslipidemias were classified according to recommendations in the literature. The statistical significance level adopted was the probability value (p) of 0.05 or less. Results: The observed frequencies of increased TC, triglycerides (TG), LDL-C and non-HDL-C (NHDL-C) were 33%, 40%, 29% and 13% respectively, and of reduced high-density lipoprotein cholesterol (HDL-C) the frequency was 39%. The frequencies, in general, were greater in females and in the southwest and south regions of the city, whose populations are more vulnerable from the socioeconomic point of view; on the other hand, in children and adolescents, the frequencies of TG and HDL-C prevailed, respectively. Conclusions: The high frequency and regionalization of dyslipidemias in children and adolescents indicate the need for specific actions in the handling and treatment of such diseases by the public health system of Campinas. (Arq Bras Cardiol. 2020; 114(1):47-56) Keywords: Cardiovascular Diseases; Dyslipidemias; Hypercholesterolemia; Child; Young Adult; Unified Health System; Adolescent; Laboratory Test. Introduction Cardiovascular diseases (CVD) represent one of the main causes of morbidity and mortality in Brazil and worldwide. According to the World Health Organization (WHO), in 2015 CVD accounted for 31% of deaths worldwide. 1 In Brazil, 29% of deaths were due to CVD according to the Brazilian Society of Cardiology. 2 Dyslipidemias play a well-established role in cardiovascular risk in adults, and so do hypertension, diabetes mellitus, early family history of coronary artery disease and smoking. Often these clinical situations are associated with comorbidities such as overweight, obesity, poor eating habits and physical inactivity, 1,3 with serious consequences for the individual and the public health system. 4 Children and adolescents account for 34% of the Brazilian population, an absolute contingent of 57,1 million people. 5 There is evidence that high levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in childhood and adolescence are associated with atherosclerotic outcomes in young adults. In this context, Napoli et al. 6 demonstrated fatty streaks in the intrauterine life span, being more noticeable in pregnant women with hypercholesterolemia. Unlike the Brazilian Dyslipidemia Directive (DBD) Update, universal lipid screening over two years of age as compared to that of children with risk factors 3 was recommended, based on other studies, by Zachariah and Johnson 7 for having a greater diagnostic sensitivity by 30% to 60%. In Brazil, there are few population studies involving dyslipidemias in childhood and adolescence. 8 In addition, the Study of Cardiovascular Risks in Adolescents (ERICA) stands out, with a national approach and covering a population of 80,000 young people between 12 and 17 years old. 8 A previous study in our laboratory characterized severe dyslipidemias in the juvenile population in a public hospital 47