Associations of Youth Weight Status Categories and Cholesterol Levels: Analysis of Data from the National Health and Nutrition Examination Survey

Obesity is recognized as a risk factor for dyslipidemia, however studies specific to overweight youth and dyslipidemia are scarce. Nonetheless, expert bodies have established BMI at the 85th percentile or greater as the threshold for “at risk” in youth and advocate for lipid screening. This study analyzed associations of weight categories and occurrence of dyslipidemia among a multi-racial sample of youth 6 to 18 years of age. In this NHANES cohort, overweight youth were at significant increased risk of dyslipidemias of total cholesterol, high-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol. Obese children and adolescents demonstrated even higher risk. This study supports the hypothesis that overweight youth are at increased risk for dyslipidemia. Despite the increased risk, test agreement for overweight and dyslipidemia was poor. BMI at the 85th percentile did not provide good discrimination in detecting children with dyslipidemia and use of this threshold warrants further review.