Background—Recently, the American Academy of Pediatrics updated guidance on lipid screening in childhood. Our objective was to examine recent distributions in concentrations of total cholesterol and low-density lipoprotein cholesterol among US children and adolescents and to estimate the prevalence of adolescents who are potentially eligible for pharmacological treatment for elevated concentrations of low-density lipoprotein cholesterol.

Methods and Results—We used data from the National Health and Nutrition Examination Survey 1999 to 2006 for participants 6 to 17 years of age. The mean concentration for low-density lipoprotein cholesterol for participants 12 to 17 years of age was 90.2 mg/dL (n=2724), and the mean concentration of total cholesterol among participants 6 to 17 years of age was 163.0 mg/dL (n=9868). Depending on the cut points used, an elevated concentration of low-density lipoprotein cholesterol was noted for 5.2% to 6.6% of participants and an elevated concentration of total cholesterol for 9.6% to 10.7%. Approximately 0.8% of adolescents 12 to 17 years of age were potentially eligible for pharmacological treatment for elevated concentrations of low-density lipoprotein cholesterol.

Conclusion—Given current guidelines, only a small percentage of US adolescents may need pharmacological treatment for elevated concentrations of low-density lipoprotein cholesterol.