Serum total cholesterol and lipoprotein cholesterol (LPC) were measured in a standardized laboratory in 3568 fasting children and youths, age 5–17 yr, in a biracial population of a total community. Between ages 11–15 yr, mean serum total cholesterol declined 3 mg/dl per year from 155 mg/dl to 143 mg/dl. Both α-LPC (7 mg/dl) and β-LPC (7 mg/dl) decreased while pre-β-LPC (2 mg/dl) increased during adolescence. Measurement errors, based upon a 10% blind duplicate random subsample, and race-sex adjustment factors, were determined for each lipid. Measurement errors were 4 mg/dl for serum total cholesterol and 6, 5 and 2 mg/dl for serum α-, β- and pre-β-LPC respectively. Measurement errors generally exceeded race-sex adjustment factors. For each fasting child serum total cholesterol was standardized for race, sex and age. Deciles for these total cholesterol relative deviates were determined. Mean total and lipoprotein cholesterol were calculated for each decile for each of the four race-sex groups. Both α-LPC and β-LPC steadily increased as the total cholesterol relative deviates increased, but the rate of increase in β-LPC exceeded that for α-LPC. As percentages of total cholesterol relative deviates. β-LPC greatly increased while α-LPC markedly decreased at higher deciles in all race-sex groups. Percentile tables for each lipid were listed with recommendations for use by clinicians caring for children in daily office practice. Guidelines were suggested for total cholesterol and LPC determinations in clinical practice. Children with a total cholesterol level greater than 185 mg/dl should have lipoproteins determined which will enable judgement for therapeutic decisions. Lipid data and lipoprotein ratios from nine selected white male adolescents in the study were presented and discussed. The results suggested a biologic link between earlier post-mortem studies of premature coronary atherosclerosis in young white male adults and epidemiologic studies of coronary heart disease in older adults. Because of the remarkable changes in lipoprotein patterns during adolescence, young men are appropriate targets for the study of methods for intervention to prevent coronary heart disease.
