Seguridad y efectividad del tratamiento con hormona de crecimiento: estudio GeNeSIS en España / Safety and efficacy of growth hormone treatment: GeNeSIS study in Spain

INTRODUCCIÓN: La información específica de cada país sobre el tratamiento pediátrico con hormona de crecimiento (GH) proviene de estudios multinacionales. MÉTODOS: En España, 1.294 niños participaron en el estudio internacional y observacional sobre genética y neuroendocrinología de la talla baja (GeNeSIS). En los pacientes tratados con GH (n=1.267) se evaluaron los acontecimientos adversos. En aquellos con deficiencia de GH (DGH, 78%) también se evaluó la efectividad. RESULTADOS: La media de edad al inicio del estudio fue 9,8 años. La mediana (Q1-Q3) de duración del tratamiento fue 2,8 (1,6-4,4) años y la dosis inicial de GH 0,22 (0,20-0,25) mg/kg/semana. En 262 pacientes con DGH con datos a 4 años, la velocidad media (IC 95%) de crecimiento fue 4,3 (4,1 a 4,6) cm/año al inicio; 9,0 (8,7 a 9,4) cm/año tras un año y 5,5 (5,2 a 5,8) cm/año a los 4 años. La puntuación de desviación estándar (SDS) de talla fue -2,48 (-2,58 a -2,38) al inicio y -1,18 (-1,28 a -1,08) a los 4 años. La SDS de talla final menos la SDS de talla diana (n=241) fue -0,09 (-0,20 a 0,02). De 1.143 pacientes tratados con GH con seguimiento ≥1 año, 93 (8,1%) comunicaron acontecimientos adversos surgidos durante el tratamiento. En 7 niños se comunicaron acontecimientos adversos graves, que en 2 casos se consideraron posiblemente relacionados con GH. CONCLUSIÓN: La terapia de sustitución con GH fue efectiva para el aumento de talla en los pacientes españoles. El perfil de seguridad fue acorde con el ya conocido para el fármaco

INTRODUCTION: Country-specific information on pediatric GH therapy is available from multi-national studies. METHODS: A total of 1294 children in Spain enrolled in the observational Genetics and Neuroendocrinology of Short-stature International Study (GeNeSIS). Adverse events were assessed in all GH-treated patients (n=1267) and effectiveness in those with GH deficiency (GHD, 78%). RESULTS: Mean age at time of entry to the study was 9.8 years. GH was initiated at a median (Q1-Q3) 0.22 (0.20−0.25) mg/kg/week and administered for 2.8 (1.6-4.4) years. For 262 patients with GHD and 4-year data, mean (95% CI) height velocity was 4.3 (4.1 - 4.6) cm/year at baseline, 9.0 (8.7 to 9.4) cm/year at 1-year, and 5.5 (5.2 to 5.8) cm/year at 4-years. Height standard deviation score (SDS) was -2.48 (-2.58 to -2.38) at baseline and -1.18 (-1.28 to -1.08) at 4 years. Final height SDS minus target height SDS (n=241) was −0.09 (−0.20 to 0.02). In 1143 GH-treated patients with ≥1 year follow-up, 93 (8.1%) reported treatment-emergent adverse events. Serious events were reported for 7 children, with 2 considered GH-related. CONCLUSION: These data confirm the benefit of GH replacement therapy on height gain for the patients in Spain. The safety profile was consistent with that already known for GH therapy

[Safety and efficacy of growth hormone treatment: GeNeSIS study in Spain]. / Seguridad y efectividad del tratamiento con hormona de crecimiento: estudio GeNeSIS en España.

INTRODUCTION: Country-specific information on pediatric GH therapy is available from multi-national studies. METHODS: A total of 1294 children in Spain enrolled in the observational Genetics and Neuroendocrinology of Short-stature International Study (GeNeSIS). Adverse events were assessed in all GH-treated patients (n=1267) and effectiveness in those with GH deficiency (GHD, 78%). RESULTS: Mean age at time of entry to the study was 9.8 years. GH was initiated at a median (Q1-Q3) 0.22 (0.20-0.25) mg/kg/week and administered for 2.8 (1.6-4.4) years. For 262 patients with GHD and 4-year data, mean (95% CI) height velocity was 4.3 (4.1 - 4.6) cm/year at baseline, 9.0 (8.7 to 9.4) cm/year at 1-year, and 5.5 (5.2 to 5.8) cm/year at 4-years. Height standard deviation score (SDS) was -2.48 (-2.58 to -2.38) at baseline and -1.18 (-1.28 to -1.08) at 4 years. Final height SDS minus target height SDS (n=241) was -0.09 (-0.20 to 0.02). In 1143 GH-treated patients with ≥1 year follow-up, 93 (8.1%) reported treatment-emergent adverse events. Serious events were reported for 7 children, with 2 considered GH-related. CONCLUSION: These data confirm the benefit of GH replacement therapy on height gain for the patients in Spain. The safety profile was consistent with that already known for GH therapy.

Asistencia al niño y adolescente con diabetes. Unidades de referencia en diabetes pediátrica / Treatment of the child and adolescent with type i diabetes: special paediatric diabetes units

El tratamiento intensivo de la diabetes mellitus tipo 1 (DM1) permite retrasar y enlentecer la progresión de las complicaciones crónicas (DCCT 1993). Este tipo de tratamiento en niños y adolescentes con DM1 tiene una complejidad diferente de la de otras etapas de la vida y por ello se necesitan Unidades de Asistencia Especializada en diabetes pediátrica. Se valoran los diferentes documentos y declaraciones sobre los derechos de los pacientes con DM1 y se enfatiza la necesidad de una adecuada asistencia sanitaria. En la última década, se han desarrollado en Europa varios proyectos para establecer una evaluación comparativa del tratamiento de la DM en edad pediátrica con el objetivo de establecer centros hospitalarios con una asistencia muy cualificada en su control. El Grupo de trabajo de Diabetes de la Sociedad Española de Endocrinología Pediátrica ha elaborado este documento con el objetivo de obtener un Consenso Nacional para la asistencia al niño y adolescente con DM1 en «Unidades de Referencia en diabetes pediátrica» y, a su vez, poder asesorar a las administraciones para establecer una Red Nacional dirigida a la asistencia del niño y adolescente con DM y organizar las Unidades de Atención Integral de la diabetes pediátrica en hospitales con nivel de referencia por su calidad asistencial (AU)

Intensive treatment of type 1 diabetes mellitus (DM1) delays and slows down the progression of chronic diabetes complications (DCCT 1993). This type of treatment in children and adolescents with DM1 has a different complexity to other stages of life and therefore, needs specialized care units. Various documents and declarations of diabetic patient's rights are evaluated, and the need for an adequate health care is emphasized. In the last decade, several projects have been developed in Europe to create a benchmark treatment of pediatric diabetes, with the aim of establishing hospitals with highly qualified healthcare to control it. The Diabetes Working Group of the Spanish Society for Pediatric Endocrinology (SEEP) has prepared this document in order to obtain a national consensus for the care of children and adolescents with type 1 diabetes in specialist Pediatric Diabetes Units, and at the same time advise Health Care Administrators to establish a national healthcare network for children and adolescents with diabetes mellitus, and organize comprehensive pediatric diabetes care units in hospitals with a reference level in quality of care (AU)

[Treatment of the child and adolescent with type 1 diabetes: special paediatric diabetes units]. / Asistencia al niño y adolescente con diabetes. Unidades de referencia en diabetes pediátrica.

Intensive treatment of type 1 diabetes mellitus (DM1) delays and slows down the progression of chronic diabetes complications (DCCT 1993). This type of treatment in children and adolescents with DM1 has a different complexity to other stages of life and therefore, needs specialized care units. Various documents and declarations of diabetic patient's rights are evaluated, and the need for an adequate health care is emphasized. In the last decade, several projects have been developed in Europe to create a benchmark treatment of pediatric diabetes, with the aim of establishing hospitals with highly qualified healthcare to control it. The Diabetes Working Group of the Spanish Society for Pediatric Endocrinology (SEEP) has prepared this document in order to obtain a national consensus for the care of children and adolescents with type 1 diabetes in specialist Pediatric Diabetes Units, and at the same time advise Health Care Administrators to establish a national healthcare network for children and adolescents with diabetes mellitus, and organize comprehensive pediatric diabetes care units in hospitals with a reference level in quality of care.

Documento consenso del Grupo de Diabetes de la SEEP: Programa de formación para la implantación del tratamiento con infusión subcutánea continua de insulina (ISCI) en pacientes pediátricos con diabetes tipo 1 / Consensus document of the Diabetes Group of the Spanish Society of Pediatric Endocrinology (SEEP): A training program to carry out treatment with continuous subcutaneous insulin infusion (CSII) in pediatric patients with type 1 diabetes

Los avances tecnológicos en los últimos años en el campo de la diabetes han permitido la aplicación de nuevas terapias para nuestros pacientes con el objetivo fundamental de mejorar su control metabólico, la calidad de vida y evitar las hipoglucemias. Esto obliga a establecer protocolos de consenso en el empleo de estas nuevas tecnologías para ser utilizadas por los distintos profesionales implicados en esta enfermedad. Este programa de formación incluye los conocimientos básicos y avanzados, para la utilización de la ISCI (AU)

Recently new technologies for the management of diabetes allow new therapeutic strategies for diabetes patients with the object of improve metabolic control, queality of life and avoid hypoglycaemias. Because physicians must be familiar with new diabetic are devices, new protocols must be establish. This article reports on the Spanish Position Statement for the Diabetes Pediatric Group for the Spanish Pediatric Endocrinology Society (SEEP) on educational program for the treatment of children and adolescent with type 1 diabetes with continuous subcutaneous insulin infusion (AU)

Ketoacidosis at onset of type 1 diabetes mellitus in pediatric age in Spain and review of the literature.

UNLABELLED: DKA at diagnosis of T1DM is a life-threatening situation that represents the main cause of morbidity and mortality in pediatric patients with T1DM. OBJECTIVE: To determine whether the occurrence and severity of DKA at diagnosis of T1DM has suffered any changes in recent years in the Spanish paediatric population. PATIENTS AND METHODS: Data from 1169 patients with T1DM under 15 years of age was retrospectively studied (2004 -2008) for the presence and severity of DKA at the onset of T1DM, and compared to previous available studies in Spain. This study is multicentric, nationwide with eleven major Paediatric Diabetes Units involved. RESULTS: Complete data were available from 1151 patients (98%). Frequency of DKA was 39.5%, which is not significantly different from previous Spanish studies. 33.8%, children of 0-4.9 years of age, 40.8% aged 5-10.9 and 25.2% aged 11-14.9 years. Mean age of patients with DKA was significantly lower than the one of patients without DKA (7.44 +/- 4.10 versus 8.47 +/- 3.63 years). Mild DKA was occurring more frequently than moderate and severe forms (47.8%, versus 34.4% versus 17.8%, p<0.0001). Incidence of severe DKA was significantly higher in children under 4.9 years of age, especially in those younger than 2 years (p<0.001). Severe DKA led to complications in three children (cerebral oedema [n=1]), cerebral infarction (n=1) and femoral vein thrombosis (n=1). CONCLUSION: Frequency of DKA at diagnosis of T1DM in Spain is still high although most cases were mild. Children under 2 years of age seem to be at increased risk for severe DKA.

Estado actual y recomendaciones sobre la utilización de los sistemas de monitorización continua de glucosa en niños y adolescentes con diabetes mellitus tipo 1 / Current status and recommendations on the use of continuous blood glucose monitoring systems in children and adolescents with type 1 diabetes mellitus

Los métodos de medición de la glucemia han presentado un gran avance en la última década con la aparición de los sistemas de monitorización continua de la glucosa (SMCG) que miden los niveles de glucosa en el líquido intersticial y ofrecen información sobre patrones y tendencias de los niveles de la glucemia pero no sustituyen el autocontrol de la glucemia capilar. La mejoría del control de la diabetes utilizando los SMCG depende de la motivación y formación recibida por el paciente y familia, así como de la continuidad en su uso. Debido al gran desarrollo y la amplia utilización en la práctica clínica de estos sistemas, el grupo de diabetes de la Sociedad Española de Endocrinología Pediátrica ha elaborado un documento de consenso para su indicación y uso en la edad pediátrica. Existe un número limitado de ensayos clínicos en población pediátrica sobre el uso de esta tecnología. Se necesitan más datos para poder valorar su impacto sobre el control metabólico (AU)

Glucose monitoring methods have made great advances in the last decade with the appearance of the continuous glucose monitoring systems (CGMS) that measure the glucose levels in the interstitial liquid, providing information about glucose patterns and trends, but do not replace the self-monitoring of capillary glucose. Improvement in diabetes control using the CGMS depends on the motivation and training received by the patient and family and on the continuity in its use. Due to the development and widespread use of these systems in clinical practice, the diabetes group of the Sociedad Española de Endocrinología Pediátrica has drafted a document of consensus for their indication and use in children and adolescents. Only a limited number of trials have been performed in children and adolescent populations. More data are needed on the use of this technology in order to define the impact on metabolic control (AU)

[Current status and recommendations on the use of continuous blood glucose monitoring systems in children and adolescents with type 1 diabetes mellitus]. / Estado actual y recomendaciones sobre la utilización de los sistemas de monitorización continua de glucosa en niños y adolescentes con diabetes mellitus tipo 1.

Glucose monitoring methods have made great advances in the last decade with the appearance of the continuous glucose monitoring systems (CGMS) that measure the glucose levels in the interstitial liquid, providing information about glucose patterns and trends, but do not replace the self-monitoring of capillary glucose. Improvement in diabetes control using the CGMS depends on the motivation and training received by the patient and family and on the continuity in its use. Due to the development and widespread use of these systems in clinical practice, the diabetes group of the Sociedad Española de Endocrinología Pediátrica has drafted a document of consensus for their indication and use in children and adolescents. Only a limited number of trials have been performed in children and adolescent populations. More data are needed on the use of this technology in order to define the impact on metabolic control.

Documento de consenso sobre tratamiento con infusión subcutánea continua de insulina de la diabetes tipo 1 en la edad pediátrica / Consensus document on continuous subcutaneous insulin infusion (CSII) treatment in paediatrics with type I diabetes

Este artículo expone el documento consenso al que ha llegado el Grupo de Trabajo de Diabetes Pediátrica de la Sociedad Española de Endocrinología Pediátrica de la Asociación Española de Pediatría sobre el tratamiento con infusión subcutánea continua de insulina en diabetes tipo 1 en la edad pediátrica. Se recogen los aspectos prácticos sobre requisitos, indicaciones, contraindicaciones, candidatos, ventajas e inconvenientes de dicho tipo de tratamiento. Las conclusiones se basan en la revisión de los consensos internacionales basados en la evidencia y en el acuerdo de los participantes (AU)

This article reports on the Spanish Position Statement for the Diabetes Pediátric Group for the Spanish Pediatric Endocrinology Society (SEEP) on continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes. The practical issues about their indications, appropriate candidates, feasibility, and limits are outlined. The conclusions are based on the comprehensive review and balanced assessment of the evidence base on the international consensus and consensual answers to these questions for the participants (AU)

[Consensus document on continuous subcutaneous insulin infusion (CSII) treatment in paediatrics with type I diabetes]. / Documento de consenso sobre tratamiento con infusión subcutánea continua de insulina de la diabetes tipo 1 en la edad pediátrica.

This article reports on the Spanish Position Statement for the Diabetes Pediátric Group for the Spanish Pediatric Endocrinology Society (SEEP) on continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes. The practical issues about their indications, appropriate candidates, feasibility, and limits are outlined. The conclusions are based on the comprehensive review and balanced assessment of the evidence base on the international consensus and consensual answers to these questions for the participants.

Hipotiroidismo subclínico / No disponible

No disponible

[Study of Navarra (PECNA). Correlation of arterial blood pressure, in a child-young population, with anthropometric and biochemical parameters]. / Estudio de Navarra (PECNA). Correlación de la tensión arterial, en una población infanto-juvenil, con parámetros antropométricos y bioquímicos.

As part of an epidemiological study on cardiovascular risk factors among children and adolescent in Navarra, arterial blood pressure (BP) readings were taken in 5,829 children. These children, both males and females, between the ages of 4 and 17 years, were selected at random from the public and private school population in our community. The correlation between systolic blood pressure and diastolic blood pressure with anthropometric and biochemical parameters was analyzed. The correlation coefficient for systolic BP readings were always higher than those for diastolic BP. The highest correlations for both BP scores were found with weight, followed by height. Correlation with total weight parameters is superior to that found with body fat parameters. There were no significant correlations between BP and the lipid parameters. When analyzing multiple regression equations, we find that with only the child's weight and age, both systolic and diastolic BP can be predicted with correlation coefficients of 0.597 and 0.492, respectively. When doing a partial correlation analysis, the correlation between systolic BP and age, at a fixed height value, disappears; while the correlation of systolic BP with height remains when using a set age. This suggest that the best definition for hypertension is based on BP-height percentile, rather than BP-age.

[The Navarra study. Prevalence of arterial hypertension, hyperlipidemia and obesity in the infant-child population of Navarra. Association of risk factors]. / Estudio de Navarra (PECNA). Prevalencia de hipertensión arterial, hiperlipidemia y obesidad en la población infanto-juvenil de Navarra. Asociación de estos factores de riesgo.

As part of an epidemiological study on cardiovascular risk factors among children and adolescents in Navarra, 5,829 children were studied. These children, of both sexes, were between 4 and 17 years of age and were selected at random from the public and private school population in Navarra. The prevalence of hypertension (HT) was 7.17 +/- 0.34%, hyperlipemia (LDL/HDL > 2.2) 15.70 +/- 0.49% and obesity (Quetelet I) 3.96 +/- 0.26%. Of the children and adolescents in Navarra 23.68% show some of these three associated risk factors. Obesity was significantly associated with HT and hyperlipemia, measured by LDL/HDL > 2.2 (but not when defined by cholesterol > 200 mg/dl). This association was greater when the pathology was defined by the Quetelet Index, rather than by the skinfold thickness. Hypertension was not associated with hypercholesterolemia (defined as LDL/HDL > 2.2). The association with hyperlipemia (measured by LDL/HDL) disappeared when the obesity effect was eliminated. It is deduced from these factors that if we don't take preventative health measures, the present children and adolescents from Navarra will suffer a high cardiovascular morbi-mortality when they become adults.

[A study from Navarra. Hyperlipidemia V. What is the best definition of hyperlipemia in childhood and adolescence?]. / Estudio de Navarra (PECNA). Hiperlipemias V. Cuál es la mejor definición de hiperlipemia en la edad infanto-juvenil?

As part of an epidemiological study on cardiovascular risk factors among children and adolescents in Navarra, lipids and lipoproteins were analyzed in 5,829 children of both sexes, between 4-17 years of age, and selected at random from the school population in our community. In this article, we analyze the different definitions for lipid risk during childhood, whether based on percentile values, according to age and sex of the child, of cholesterol, LDL/cholesterol, or risk quotients (C/HDL, LDL/HDL), or even on the absolute values of all of these parameters. An appropriate definition for hyperlipemia during childhood, once we know the average variations in the levels of lipids and lipoproteins according to age and sex, as well as the variations of the lipid risk prevalence according to its definition, would be: 1. Previous screening according to cholesterol serum levels: Values higher than the 70th percentile for each group according to age and sex: or higher than 185 mg/dl for children age 4 to 12 and 170 mg/dl for children age 13 to 17. 2. To calculate the LDL/HDL quotient among those selected children included in the definition of hyperlipemia when the quotient is higher than the 85th percentile for the patients age and sex, or it is higher than 2.2.

[A study from Navarra. Hyperlipidemias. Avarage scores and percentiles for lipids and lipoproteins in a population of children and adolescents. Correlation with anthropometric parameters]. / Estudio de Navarra (PECNA). Hiperlipidemias. Valores medios y percentilados de lípidos y lipoproteínas en una población infanto-juvenil. Correlación con parámetros antropométricos.

As part of an epidemiological study on cardiovascular risk factors among children and adolescents in Navarra, the following parameters: total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and C/HDL and LDL/HDL risk quotients were determined in 5,829 children. These children, of both sexes and between the ages of 4 and 17 years, were selected at random from the school population in our community. Average values and percentiles of these parameters were obtained for each group according to age and sex as a previous step to define the health condition or "lipid risk" in our population. When determining the correlation of these biochemical parameters with the anthropometrical parameters of BP, age, weight, height, Quetelet Index, body mass surface, skinfold thickness and the percentage of subcutaneous fat (after the necessary logarithmic transformations, adjusted to each age and sex group by Z-scores) we find that none of the correlation coefficients are significant. The triglycerides and the HDL-cholesterol have a low, but significant. The triglycerides and the HDL-cholesterol have a low, but significantly, correlation with the other lipid parameters. The lipid risk quotient (C/HDL, LDL/HDL) shows a higher correlation with LDL-cholesterol than with total cholesterol.

[The Navarra study (PECNA). Hyperlipidemia III. Variations in the median HDL levels and lipid risk quotient in children and adolescents based on age and gender]. / Estudio de Navarra (PECNA). Hipelipemias III. Variaciones de los niveles medios HDL y de los cocientes de riesgo lipídico de una población infanto-juvenil según edad y sexo.

As part of an epidemiological study on cardiovascular risk factors among children and adolescents in Navarra, lipids and lipoproteins were analyzed in 5,829 children of both sexes. The subjects were between 4 and 17 years of age and were selected at random from the school population in our community. In this article we analyze the variations in HDL-cholesterol and cholesterol/HDL and LDL/HDL risk quotients according to age and sex. Beginning at the age of 10, the HDL decreases in both sexes, although this decrease is more evident among males and they obtain levels lower than those during early childhood. Among females older than 14 there is a slight increase. Apparently the decrease in HDL among male adolescents is due to an increase in the production of testosterone during this stage of life. Both risk quotients decrease until the children are 10 years of age, after which they increase among males and stabilize or slightly decrease among females. For this reason, scores are higher for males during the last years of adolescence. The cardiovascular lipid risk increases with age and during adolescence in higher among males and depends more on the variations in HDL than on variations in cholesterol or LDL. We believe that the best definition for cardiovascular lipid risk during the infancy or adolescents is one which is based on the risk quotients.

[The Navarra study (PECNA). Hyperlipidemia IV. Prevalence of hyperlipidemia in the infant- and juvenile population of Navarra. Variations based on age, gender and health care accessibility]. / Estudio de Navarra (PECNA). Hiperlipemias IV. Prevalencia de Hiperlipemias en la población infanto-juvenil de Navarra. Variaciones según edad, sexo y Areas Sanitarias.

As part of an epidemiological study on cardiovascular risk factors among children and adolescents in Navarra, lipids and lipoproteins were analyzed in 5,829 children of both sexes. These children were between 4 and 17 years of age and were randomly selected from the school population of our community. In this article, we analyze the prevalence of lipid risk, according to its different definitions, among children and adolescents in Navarra, and its variations related to age, sex and sanitary area. The prevalence of hypercholesterolemia (C > 200 mg/dl) among children and adolescents, aged 4 to 17 years, is very high: 21.07% +/- 0.54%. In spite of having high serum levels of HDL, the lipid risk measured by the risk quotient LDL/HDL > 2.2 is still very high: 15-70% +/- 0.49%. If we define the lipid risk during childhood and adolescence by the quotient LDL/HDL > 2.2, male adolescents turn out to be the group with the highest risk. This phenomenon coincides with the results of the epidemiological studies made among adults. Nevertheless, they do not coincide with these results if the lipid risk is defined by C > 200 mg/dl. In our opinion, during infancy and adolescence, the lipid risk is better defined by the quotient LDL/HDL > 2.2.

[Study from Navarra. Variations in the average arterial blood pressure level according to age, gender and body height]. / Estudio de Navarra (PECNA). Variaciones de los niveles medios de tensión arterial según edad, sexo y talla.

As part of an epidemiological study on cardiovascular risk factors among children and adolescents in Navarra, arterial blood pressure (BP) readings were taken in 5,829 children, including both sexes and aged between 4 and 17 years. The subjects were randomly selected from the public and private school population in our community. BP-age and BP-height percentiles were obtained for each sex and the physiological variations in BP according to these parameters was also analyzed. Systolic BP increased with age in both sexes throughout childhood. During adolescence, there is almost no variation in BP among girls, but in boys older than 13 years, there is a sudden increase. For this reason, boys have higher values than girls. Diastolic BP shows a linear increase in both sexes. BP increases with height in both sexes. In spite of the sudden rise in systolic BP among the boys taller than 145 cm, the increase in systolic BP in relationship to height is smaller and more homogeneous than the increase seen with age. As the BP variations with height are smaller and more homogeneous than those related to age, it is preferable to evaluate this parameter by BP-height rather than by BP-age.

[Study from Navarra. Hyperlipidemia II. Variations according to age and sex in the average cholesterol level, LDL-cholesterol and triglycerides in an infant-child population]. / Estudio de Navarra (PECNA). Hiperlipemias II. Variaciones de los niveles medios de colesterol total, LDL-colesterol y triglicéridos de una población infanto-juvenil según edad y sexo.

As part of an epidemiological study on cardiovascular risk factors among children and adolescents in Navarra, lipids and lipoproteins were analysed in 5,829 children. The study group was selected at random from the school population in our community and included students of both sexes between 4 and 17 years of age. In this article we describe the variations from 4 to 10 years of age in both sexes and decrease from that age on. Among males older than 14, they continue decreasing, while they become stable in females. For this reason, values during childhood are higher than during adolescence in both sexes, and within this period, males show lower levels than girls. Variations in LDL serum levels according to age and sex are similar to those recorded with cholesterol. The triglyceride serum levels increase in line with age among boys. With girls, something similar happens until they are 13. Starting from this age, there is an inversion showing lower levels than the male adolescents. In both sexes, levels during adolescence are higher than during childhood.