Prevalence of and factors associated with lipid screening in young people aged 16- to 21 years in the United States: analysis of nationwide cross-sectional data.

Background & aims: There is no consensus on whether it is worthwhile for young people to undergo lipid screening. An estimate of the national prevalence of lipid screening in this population can serve as a basic parameter in analyses of the utilization and cost-effectiveness of health care services. Previous studies were mostly based on electronic health records or insurance claims data or were restricted to adolescents at younger ages. This study aimed to investigate the prevalence of lipid screening and the factors associated with it in young people aged 16- to 21 years in the United States based on a nationally representative sample.

Methods: A cross-sectional study of 16- to 21-year-old participants from the National Health and Nutrition Examination Survey (NHANES), 2013-March 2020 (four cycles), was conducted. The prevalence of lipid screening uptake was calculated for each cycle as well as for all four cycles combined, and the associations of lipid screening uptake with the covariates were analysed by logistic regression. An appropriate sample weight was incorporated into the analysis as recommended.

Results: A total of 3,600 participants were included in the analysis, and 32.02% of them had ever received lipid screening at the time of the survey, with no statistically significant secular changes observed over the four cycles. Among the participants, 28.83% received lipid screening within the past 5 years. In multivariable regression analysis adjusted for all covariates, non-Hispanic black ethnicity (adjusted odds ratio [AOR]: 1.43), having health insurance (AOR: 1.54), obesity (AOR: 1.65) and sufficient physical activity (AOR: 1.36) were significantly associated with a greater chance of ever receiving lipid screening.

Conclusions: Nearly one-third of young people aged 16- to 21 years in the United States have received lipid screening. Ethnicity, health insurance, weight problems, and physical activity level were associated with the likelihood of lipid screening uptake. These findings could help people understand the current situation of lipid screening in young people in the United States and may serve as fundamental parameters in the assessment of the utilization and cost-effectiveness of related health care services.