270

MEAN SERUM CHOLESTEROL IN MG. PER 100 ML,

150

Figure 4. MEAN SERUM CHOLESTEROL LEVELS OF CHILDREN AGED 1-17 YEARS AND ADULTS AGED 18-74 YEARS BY AGE AND SEX:
UNITED STATES, 1971-74

AGE IN YEARS

DISCUSSION AND
CONCLUSION

The level of serum cholesterol has been iden-
tified as one of the multiple risk factors in the
development of coronary heart disease. The re-
sults of epidemiological studies based on adult
data from longitudinal studies such as the Fram-
ingham Heart Study® have demonstrated that
persons with elevated serum cholesterol values
developed coronary heart disease with greater
frequency. Similar longitudinal data obtained
from adolescents that relate serum cholesterol

levels in younger ages to future morbidity or
mortality are not available. There is some evi-
dence, however, that atherosclerosis, more fre-
quently manifested by coronary heart disease,
may originate in childhood. Holman and others
reported finding evidence of atherosclerosis in
post mortems of children.6 Enos and others
reported gross evidence of coronary athero-
sclerosis in 77 percent of American soldiers,
average age of 22 years, killed in the Korean
War.7

Reference data of levels of children 4-17
years of age were presented and analyzed by age,


10 advancedata

STATISTICAL NOTES

The sampling plan for the 65 preselected ex-
amination locations in the Health and Nutrition
Examination Survey followed a highly stratified
multistage probability design in which a sample
of the civilian noninstitutionalized population of
the conterminous United States 1-74 years of
age was selected. Successive elements dealt with
in the process of sampling were the primary sam-
pling unit, census enumeration district, segment
(a cluster of households), household, eligible
person, and finally, sample person. The sampling
design provided for oversampling among persons
living in poverty areas, preschool children, wom-
en of childbearing age, and the elderly.

The serum cholesterol determinations are
shown as population estimates; that is, the ser-
um cholesterol findings for each individual have
been “weighted” by the reciprocal of the proba-
bility of selecting the person. An adjustment for
persons in the sample who were not examined
and poststratified ratio adjustments were also
made, and so the final sampling estimates of the
population size were brought into closer align-
ment with the independent U.S. Bureau of the
Census estimates for the civilian noninstitution-
alized population of the United States as of
November 1, 1972, by race, sex, and age.


advancedata

Table 1. Scrum cholesterol levels of children 1-17 years by sex and age with mean, standard deviation, and standard error of mean:

United States, 1971-74

Both sexes Boys Girls
Age Standard Standard Standard
Meant | Standard | oor of | Mean? | Standard | oicr of | Meant | Standard | orror of
deviation deviation deviation
mean mean mean

165.4 34.9 t 167.2 38.5 t 163.2 29.6 +
176.6 33.7 t 172.5 36.2 t 180.6 30.6 t
170.8 31.6 t 167.7 29.3 t 1743 33.6 t
1729 30.2 2.08 171.3 28.7 1.97 174.7 31.7 3.52
1726 36.2 1,84 168.9 35.8 2.66 176.0 36.1 2.80
173.6 30.0 2.22 170.1 26.8 2.07 1774 32.5 3.93
175.4 30.7 2.81 1758 28.1 4.45 175.0 33.4 2.95
180.0 30.1 2.21 173.4 27.6 2.63 186.5 31.2 3.14
183.9 35.2 2.49 182.5 366 3.43 185.2 33.8 3.00
181.5 32.6 2.48 181.4 25.4 2.43 181.6 38.2 4.24
179.2 32.8 2.74 181.4 32.4 3.16 176.8 33.0 3.49
177.7 33.3 2.54 179.9 37.0 3.95 175.0 27.9 3.51
Ins 37.7 2.67 1733 40.4 4.45 170.4 35.2 3.16
171.0 34.7 1,83 169.1 36.8 2.80 1728 32.4 2.82
173.2 35.2 2.59 168.8 33.9 3.08 177.8 35.9 4.12
ins 32.0 1.87 168.6 29.3 2.89 174.0 34,3 3.04
173.3 33.7 2.64 167.5 30.9 3.18 180.6 35.7 3.44

Mg per 100 ml.

Standard error of mean not included because of possible bias due to missing values.

SYMBOLS

Data not available

Category not applicable------——_—e
Quantity zero——_-—_——__--______--__- -
Quanity more than 0 but less than 0.05——- 0.0

Figure does not meet standards of
reliability or precision:



6 advancedata

sex, and race because of the medical interest in
such data. There are no such previous data for
the general population of ages 4-17 years. Such
data as are available are taken from selected seg-
ments of the population and special study
groups. Such estimates could not be generalized
to the U.S. population. HANES, on the other
hand, provided cross-sectional data of serum cho-
lesterol levels obtained on different age cohorts
representative of the U.S. population. The age
trends represented mean levels for successive co-
horts of persons of different age groups. The
limitation of cross-sectional data are recognized
in considering group changes because they re-
flect effects of environment as well as develop-
mental and hereditary influences.

Girls in most ages had higher mean serum
cholesterol levels than boys. By race and sex,
white girls generally had higher mean serum cho-
lesterol levels than white boys of comparable
ages. Similarly, among Negroes, girls had higher
mean levels than boys. For both whites and Ne-
groes, only boys of ages 11 and 12 years had
higher mean serum cholesterol levels than girls
of comparable age.

At each age group, with few exceptions, Ne-

gro boys had higher mean levels than white
boys. This pattern is also evident for Negro girls
as compared to white girls. The differences -in
mean levels between white and Negro were
greater for girls than for boys. The average dif-
ferences between the mean levels of whites and
Negroes over the 14 ages was 7.1 mg per 100 ml
for females and 3.8 mg per 100 ml for males.
The mean serum cholesterol level obtained
for males age 17 years is consistent with the
finding that serum cholesterol levels rise sharply
with age for young men. Similar analysis of the
mean cholesterol level for females age 17 years
with those of females age 18-24 years shows that
the mean values rise less rapidly than those of
males. The increase in mean cholesterol levels
observed in the data for females between the
ages of 16 and 17 years is followed by an in-
crease during the age group 18-24 years and a
continued rise in serum cholesterol level among
females in the 25-34 and 35-44 age groups,
whereas in adult males the rise is not only more
rapid but it begins earlier. Not only are the mean
serum cholesterol levels higher in adults than in
children but also the distributions have greater
variability in adults than in children aged 4-17.

REFERENCES

1 National Center for Health Statistics: Plan and oper-
ation of the Health and Nutrition Examination Survey,
United States, 1971-73. Vital and Health Statistics, Ser-
ies 11, Nos. 10a and 10b. DHEW Pub. No. (HSM)
73-1810. Health Serivces and Mental Health Administra-
tion, Washington. U.S. Government Printing Office, Feb.
1973.

2National Center for Health Statistics: Serum choles-
terol levels of children 4-17 years of age, United States,
1971-74. Vital and Health Statistics. Series 11. Health
Resources Administration, DHEW, Rockville, Md. In
preparation.

Abell, L.L.; Levy, G.B.; Brodie, B.B.; and Kendall,
F.E.: A simplified method for the estim ation of total
cholesterol in serum and demonstration of its specificity.
J. Biochem, 195:357, 1952.

4¥Eavenson, D.; Grier, O.T.; Cisson, J.G.; and Witter,
R.F.: A semiautomated procedure for the determination
of serum cholesterol using the Abell-Kendall Method. ].
Am, Chem. Soc. 43:652, 1966.

5Kannell, W.B.; Castelli, W.P.; Gordon, T.; and Mc
Namara, P.M.: Serum cholesterol, lipoproteins, and the
risk of coronary heart disease. Ann. Intern. Med.
74:1-12. 1971.

Holman, R.L.; McGill, H.C.; Strong, J.P.; and Geer,
J.C.: The natural history of atherosclerosis: The early
aortic lesions as seen in New Orleans in the middle of the
20th century. Amer. J. Pathol. 34:209-235, 1958.

TEnos, W.J.; Holmes, R.H.; and Beyer, J.: Pathogene-
sis of coronary heart disease in American soldiers killed
in Korea, JAMA 158:912-914, 1955.


‘Table 4. Cumulative percent distribution of serum cholesterol levels of girls aged 1-17 years by age: United States, 1971-74

Serum

cholesterot 1 2 3 4 5 6 7 8 9 wo | mf 12 | 13 | wm | 15 | 6 | 17
evel year | years | years | years | years | years | years | years | years | years | years | years | years | years | years | years | years
{eng/100 mi)
Cumulative
Under 100 nnununne| 285] 0.0] 1,04) 1.25) 00) 201] 0.26) 00) 00) 279) 145) 0.14

049] 144] 00) 279) 145] 0.14
o4g| 241| 2.74) 361] 456] 223
425| 422| 359| se1| S94] 3.27

population in
thousands ...

757| 998] 1,206 | 1,642 | 1,687| 1,718] 1,812 | 1,906] 1,950] 1,980} 2,018 | 2,059 | 2.054 | 2,040] 2,038 | 2,012 | 1,985

Table 5. Serum cholesterol levels of persons by sex and age, with number of persons examined, mean, and standard deviation: Unitea
States, 1971-74

Male Female
Number 1 | Stendard | Number 1 | Standard
Age examined | Mean Deviation | examined | Me2” Deviation
cra 168.8 239 im 1778 359
169 168.6 29.3 175 174.0 343
176 1675 309 157 180.6 357
772 186.9 367| 1,524 1917 41.0
124 178.6 29.2 144 175.4 344
135 1744 26.4 137 186.3 369
104 183.1 257 236 188.6 38.2
112 186.2 344 287 198.1 458
107 190.7 38.3 249 197.9 40.1
94 200.5 34.1 253 198.0 44.3
96 i954 39.8 248 196.7 39.6
804 2103 440| 1,896 203.2 42.2
66s 2313 459| 1.663 2165 435
765 239.4 47.0 836) - 242.6 52.0
597 240.2 61.2 670 256.8 48.2
1,687 236.2 538 4,822 261.6 519

4Mg per 100 mi.


dvancedat

FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS

US. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE | No. 8

July 11, 1977 | Public Health Service - Health Resources Administration

Total Serum Cholesterol Levels
of Children 4-17 Years of Age, United States, 1971-742

Serum cholesterol levels of children 4-17
years of age in this report were obtained as part
of the Health and Nutrition Examination Survey
(HANES). HANES is a program of the National
Center for Health Statistics in which measures of
nutritional status are collected for a scientifi-
cally designed sample representative of the civil-
jan noninstitutionalized population of the Uni-
ted States in the broad range of ages 1-74
years.!

Field data collection operations for the first
HANES survey were started in April 1971 and
completed in June 1974. Of the 28,043 persons
aged 1-74 years who were selected in the nation-
al probability sample to represent the 194 mil-
lion persons in that age in the civilian noninstitu-
tionalized population, 20,749, or 74.0 percent,
were examined. When adjustments are made for
the differential sampling ratios used for the ef-
fect of oversampling among the poor, preschool
children, women of childbearing age, and the el-
derly, this figure corresponds to an effective re-
sponse rate of 75 percent. Among children 4-17
years of age at interview for whom serum choles-
terol determinations were made, there were
5,334 examined out of the probability sample of
6,356 selected to represent the 56 million of this
age in the population. This is an unadjusted re-
sponse rate of 84 percent and an effective ad-
justed response rate of 84 percent.

Detailed estimates of the distribution of se-
rum cholesterol levels will be described and ana-
lyzed in the report “Total Serum Cholesterol
Levels of Children 4-17 Years, United States,

This report prepared by Sidney Abraham, Clifford
L, Johnson, M.S.P.H., and Margaret D. Carroll, M.S.P.H.

1971-1974,” Vital and Health Statistics Series
11.2 Selected data and findings from that re:
port are presented here in tables 1-5 and figures”
14,

CHOLESTEROL DETERMINATIONS

All serum cholesterol determinations were
made in the Lipid Standardization Laboratory
of the Center for Disease Control (CDC), Public
Health Service, Atlanta, Georgia. The analytical
method was based on that of Abell and others?
but was modified for a semiautomated produc-
tion line. The method described in detail by
Eavenson and others* was made possible by the
development of a relatively stable Liebermann
color reagent and was designed for automatic
pipetting units.

The Lipid Laboratory at CDC compared the
results obtained with this semiautomated Abell
method and those obtained from their standard-
ized version of Abell and others. For examining
the bias of the semiautomated method, data
were obtained from pools of sera analyzed by
the reference method and the semiautomated
method. For pools ranging from 134 to 343 mg
per 100 ml, there was in 1972 an average posi-
tive bias of 4.07 percent for the semiautomated
method as compared to the standard method;
for the 1971-1974 period the corresponding fig-
ure was a positive bias of 4.9 percent. The
weighted average bias was 4.5 percent. In this
paper the 1971-1974 data are presented without
correction for bias so that they provide popula-
tion reference standards for determinations made
by the semiautomated methodology now in use.


n

Previous issues of Advance Data From Vital and Health Statistics

No. 1.

No. 3.

No. 4.

No. 5.

No. 6.

Blood Pressure of Persons 6-74 Years of Age in the United States
(Issued: October 18, 1976)

. Hypertension: United States, 1974 (Issued: November 8, 1976)

Height and Weight of Adults 18-74 Years in the United States (Is-
sued: November 19, 1976)

Prevalence of Dermatological Diseases Among Persons 1-74 Years of
Age, United States (Issued: January 26, 1977)

A Comparison of Levels of Serum Cholesterol of Adults 18-74 Years
of Age in the United States in 1960-62 and 1971-74 (Issued: Febru-
ary 22,1977)

Dietary Intake of Persons 1-74 Years of Age in the United States
(Issued: March 30, 1977)

. Total Serum Cholesterol Levels of Adults 18-74 Years of Age, Uni-

ted States, 1971-74 (Issued: May 25, 1977)



8 advancedata

Table 2. Serum cholesterol levels of white and Negro children 1-17 years by sex and age with mean, standard deviation, and standard
error of mean. United States, 1971-74

White Negro
Boys Girls Boys Girls
Age s Standard Standard Standard Standard
Mean! | srerse | error of [Mean | 512008" | error of Mean? | $'2°22"9 | ‘crror of |Mean? | St2nd2"9 | crear of
mean mean mean mean
1 year 166.5 40.2 t| 162.4 30.0 711705 28.2 t| 176.6 19.4 t
2 years. 172.8 36.3 t | 180.3 30.1 t | 175.6 31.5 Tt} 181.4 33.0 t
3 years... | 168.0 29.2 +4 172.2 33.3 + | 1706 30.0 t| 1924 29.0 t
4 years.....| 170.5 28.4 2.27 | 173.8 32.6 3.93 | 175.6 30.5 5,50] 177.1 25.4 5,03
5 years...... | 168.0 35,7 2.69 | 173.2 35.6 3.36 | 174.3 36.2 8,84 | 190.3 35,9 6.46
6 years......| 168.7 26.9 2.41 | 177.8 31.7 3.96 | 176.3 25.7 5.15 | 175.3 35,2 6.60
7 years... | 174.5 27.6 4.64 | 172.8 32.8 3.44 | 185.1 29.9 6.21 | 186.9 34.5 6.82
B years uu | 171.5 26.8 3.15 | 183.6 30.5 3.35 | 186.0 28.5 4.97 | 202.8 29.7 7.52
9 years...... | 182.0 35.9 4,07 | 183.6 33.9 3.46 | 184.5 39.1 6.89 | 194.1 29.5 5.71
10 years... | 182.9 25.1 2.57 | 179.9 39.8 4.83 | 172.0 26,2 5,59 | 192.2 25.0 5.18
11 years... | 180.8 31.7 3.49 | 179.0 31.3 3.34 | 185.7 36.9 8.04 | 164.6 38,7 | 10.29
179.0 37.2 4.34 | 177.1 26.9 4.19 | 184.1 36.1 6.61 | 166.0 31.1 7.50
1743 40.2 5.14 | 168.3 38.7 3.52 | 167.2 41.1 7.90 | 183.6 28.9 5.98
169.6 35.8 3.17 | 171.4 30.8 3.03 | 161.8 40.7 8.66 | 175.1 38.0 7.58
166.3 28.1 2.70 | 174.4 33.6 3.55 | 169.7 29.4 3.49 | 194.5 41.5] 12.36
167.2 28.8 3.28 | 173.3 34.4 3.50 | 178.7 30.7 5.62 | 182.4 31.7 8.44
166.9 30.8 3.61 | 180.3 35.8 3.93 | 173.8 32.2 7.92 | 183.3 36.3 7.40
1 Mg per 100 ml.
Standard error of mean not included because of possible bias due to missing values.
Table 3, Cumulative percent distribution of serum cholesterol levels of boys aged 1-17 years by age: United States, 1971-74
Serum
cholesterol 1} 2/3 s |6 | 7 |e | 9 | w Ja | 12 | 1 | fas | we | ov
ina yf Yo | vere | vere years | years | yeors | yeors | years | years | yeors | years | years | years | years | years | years

Cumulative percent distribution

00) 159) 042) 0.0) 00) 00) 00) 00) 00) O19] 0.16) 026) 030; 00; 00
071] 224| 108} 0.0] 012| 1.78} 063] 00] 050/ 213] 1.10] 3.28] os1| 00) 098
239] 330| 287] o67| 142] 314) 063] 045] 240] 213| 1137] 514) 3.21] O16] 3.32
7.46| 685| 1184] 3.28] 318| 609) 289] 255] 974] 313| 7.49] 1042| 7.06) 297| 844

17.12] 1286| 1846 | 10.80] 662] 10.86| 925] 391 | 19.18] 7.55) 16.68| 22.58] 15.53] 16.13 | 19.35
28.11| 21.55] 28.63} 19.98| 19.61| 16.22) 1635] 875 | 27.94] 17.01 | 27.93| 31.83] 24.64) 33.46 | 35.20
4190| 3184] 43.53 | 38.67| 28.47| 2859] 27.17| 18.45 | 36.57 | 27.13] 42.73 | 43.37| 40.13 | 43.33 | 45.19
85.34] 45.22| 87.35 | 5047| 42.43| 48,85 35.25| 32.38 | 50.79] 44.05 | 53.00} 55.75) 57.94| 55.76 | 57.51
69.01 | 63.60] 66.71 | 71.91| 61.58| 6210] 47.67| 51.60 | 62.00| 54.15 | 63.45 | 64.09) 69.08 | 73.14 | 67.01
79.05} 79.19| 74.37 | 81.586} 71.38| 74.69| 62.25| 64.43 | 70.20] 67.42| 74.11 | 77.38| 62.48 | 78.24 | 7697
a650} 85.44{ 81.05 | 89.02} 81.96| 34.64) 74.71| 7837 | 7891 | 78.85| 77.54] 9247| 99.35] 98.01 | 81.37
29,72] 91.78 | 90.26 | 96.14| 87.:04| 87.96| 88.51 | 86.03) 35.24) 84.75 | 85.15] 98.09| 93.75 | 89.63 | 87.63
94.74| 95.49 | 93.73 | 97.64] 91.92| 94.96) 92.36] 92.22 | 9393 | 29.44] 91.16] 91.31] 94.72] 91.75 | 95.21
96.18| 96.78 95.71 | 98.26] 9620| 97.22| 94.54| 95.18 | 96.75 | 94.25| 94,58 | 93.88 | 95.41 | 95.03 | 95.99
98.72} 97.69 | 96.69 | 98.62] 99.71| 99.37] 94,75| 98.08 | 97.72| 95.89] 95.64 | 95.39 | 95.80 | 95.70 | 99.07
99.53| 99.93| 97.57 | 98.77| 99.71| 99.65] 94.87| 99.83 | 92.66 | 96.33 | 97.62 | 97.09| 97.57 | 99.03 | 100.00
100.00 | 100.00 | sa. | 98.77) 99.71] 99.65| 94.87| 99.88 | 98.66 | 98.12| 97.84] 98.40| 98.40 | 99.72 | 100.00
100.00 | 100.00 | 99.53 | 98.77| 99.81} 100.00] 96.40 | 100.00 | 99.35 | 98.25 | 97.84| 98.51| 98.40 | 99.72 | 100.00
100.00 | 100,00 | 100.00 | 100.00 | 100.00 | 100.00 | 100.00 | 100.00 |100.00 | 100.00 | 100.00 | 100.00 | 100.00 | 100.00 | 100.00

Examined
children 133] 168| 224] 304! 273| 179) 164| 152] 169] 194| 178] 200] 174) 174) 171] 169| 176
Estimated

population in

thousands 793| 1,042 | 1,284| 1,707 | 1,720| 1,783] 1.879] 1,977] 2,032] 2,054| 2,095 | 2,196 | 2.125] 2,111| 2,106 | 2,072] 2,007



4 advancedata

MEAN SERUM CHOLESTEROL IN MG PER 100 ML

Figure 3. MEAN SERUM CHOLESTEROL LEVELS OF GIRLS AGED 1-17 YEARS BY AGE AND RACE: UNITED STATES, 1971-74
210 =

AGE IN YEARS

level may be found in table 3 for boys and in
table 4 for girls.

The U.S. estimates of serum cholesterol lev-
els of children aged 4-17 can be compared with
those reported in HANES for adults of ages
18-74 years. Table 5 shows the mean serum
cholesterol levels of children and adults ob-
tained in 1971-1974 by age and sex with the
standard deviations of the population distribu-
tion. Figure 4 shows the adult mean levels as
a continuation of the mean levels of those pre-
sented for children of individual ages of 4-17
years.

Males show a mean serum level of 167.5 mg
per 100 ml at age 17 after a consistent decline
from a mean level of 182.5 mg per 100 ml at age
9. The mean levels for adult males in the age
group 18-24 is 186.9 mg per 100 ml, an increase
of 19.4 mg per 100 ml, or 11.6 percent, from
the mean level at age 17. The mean levels for
male adults increase rapidly to the age group
35-44 and increase less rapidly in the age groups
45-54 and 55-64 years. A slight decline occurs in
the age group 65-74 years.

A similar analysis of the mean level at age 17
for girls with that at ages 18-24 for females also
shows a rise in mean levels. The mean level in-
creases to the age group 45-54 years and in-
creases less rapidly in the later age groups. The
rise in mean level among men does not start un-
til the early adult ages, 18-24 years, whereas in
females the rise begins earlier.

The mean levels for women are higher than
those for men in the youngest age group, 18-24
years. The mean levels for women increase less
rapidly than those for men in the age groups
25-34 and 35-44 years but increase much more
rapidly than men’s levels after age 55, The mean
levels for women are about the same as those for
men in the age group 45-54 years. The mean
levels for men peak at ages 55-64 years and then
decline, while the mean levels for women con-
tinue to rise.

The mean levels in adults are consistently
higher than those in children aged 4-17 years.
Table 5 shows that the distributions have greater
variability in adults than in children of ages 4-17
years.


for white boys separately (table 2, figure 2).
Mean cholesterol levels of white boys were high-
est at 9-11 years and decreased with age. For
Negro boys the peaks in values were at ages 7-12
years, with the exception of a drop in mean
value at age 10 years, and then a decline in mean
value from 184.1 mg per 100 ml at age 12 years
to alow of 161.8 mg per 100 ml at age 14 years.
From 14 years on the mean levels increased
rapidly to 178.7 mg per 100 ml at age 16 and
then declined (table 2 figure 2). At every age
except ages 10, 18, and 14 years Negro boys had
higher mean serum cholesterol values than white
boys.

The age-cholesterol pattern found for girls in
the total population was generally found for
white and Negro girls separately. The mean
serum cholesterol values of white girls increased
irregularly from an average value of 173.5 mg
per 100 ml at ages 4-5 years to the highest mean
value of 183.6 mg per 100 ml at ages 8-9 years
and then declined to 168.3 mg per 100 ml at age

13 years. Thereafter with age there was a general
increase in mean level to 180.3 mg per 100 ml at
age 17 years (table 2 and figure 3).

The mean levels of Negro girls also increased
irregularly each year from 177.1 mg per 100 ml
at age 4 to a peak of 202.8 mg per 100 ml at age
8. From this highest mean level at age 8 there is
a decrease in mean values through age 12 and
then a general increase to 194.5 mg per 100 ml
at age 15. At ages 16 and 17 years the mean
cholesterol levels declined from those at age 15
(table 2 and figure 3). At each age, with the
exception of ages 6, 11, and 12 years, Negro
girls had a higher mean serum cholesterol levels
than white girls.

Both white and Negro girls generally had
higher mean cholesterol levels than their male
counterparts, particularly Negro girls. In addi-
tion, Negro boys and girls had generally higher
mean serum levels than their white counterparts.

The proportion of children in HANES whose
serum cholesterol levels exceeded any specified

Figure 2, MEAN SERUM CHOLESTEROL LEVELS OF BOYS AGED 1-17 YEARS BY AGE AND RACE: UNITED STATES, 1971-74

200 =

2 woh

8

€ wl

g

g

z

a

2

Bk

3

&

3 woh

z

a vob

2
aan i n L L ! i
1 2 3s «# 6S 6 7 8

AGE IN YEARS.



For serum cholesterol measurements, suffi-
cient numbers are available for presenting chil-
dren in single years of age, from age + to 17. All
such ages are presented by sex and race. The
number of missing serum cholesterol test valucs
was acceptable for children of ages 4 through 17
years. This was not the case for serum cholesterol
values for children of ages 1-3 years, which are
nevertheless presented, but were not analyzed be-
cause of possible bias due to missing values.

PRINCIPAL FINDINGS

The mean serum cholesterol level of boys in
the younger ages from 4 through 11 years tends
to increase with age to a high average value of
181.8 mg per 100 ml at ages 9-11 years. Another
pattern in mean values is observed from these
ages through 17 years, when the mean values
consistently declined to a low mean value of
167.5 mg per 100 ml at age 17 years (table 1,
figure 1). Table 1 and figure 1 also show that the
mean values of girls were relatively stable at ages

4-7 years, ranging from 174.7 to 177.1 mg per
100 ml with the mean values increasing abruptly
to 186.5 mg per 100 ml at age 8. From this age
on through age 13 years the mean levels con-
sistently decreased from the peak at age 8 to
170.4 mg per 100 ml at age 13 years, a decrease
in mean level of 16.1 mg per 100 ml. This direc-
tion is not evident at ages 14 through 17 years,
when the mean levels increased irregularly each
year from 172.8 mg per 100 ml at age 14 years
to 180.6 mg per 100 ml at age 17 years.

Overall, the mean serum cholesterol levels
for girls increased from 174.7 mg per 100 ml at
age 4 years to 180.6 mg per 100 ml at age 17
years, an increase of 5.9 mg per 100 ml. The
decrease in mean levels between similar ages for
boys is slightly less, 3.8 mg per 100 ml. Girls in
each age group except ages 7, 11, 12, and 13
years, had higher mean serum cholesterol levels
than boys in the same age group.

The main serum cholesterol patterns ob-
served previously for the total male population
aged 4-17 years were similar to those observed

Figure 1, MEAN SERUM CHOLESTEROL LEVELS OF CHILDREN AGED 1-17 YEARS BY AGE AND SEX: UNITED STATES, 1971-74

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AGE IN YEARS