What is the National Cholesterol Education Program (NCEP)?

Updated: Jun 27, 2019
  • Author: Henry J Rohrs, III, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

The goal of the National Cholesterol Education Program (NCEP) created in 1985 by the National Heart, Lung, and Blood Institute (NHLBI) is to educate both the public and medical professionals about the benefits of lowering cholesterol levels so as to reduce the risk for coronary heart disease. Pediatric guidelines for cholesterol screening are based on a consensus report that is updated periodically. [15, 16, 17, 18]

Abnormalities in lipid levels were initially defined as concentrations at or above the 95th percentile for TC, TGs, and LDL-C for age and sex, whereas low HDL-C concentrations were defined as lower than the 5th percentile for age and sex (see Table 3 below). Many of these cutoffs have been modified by the NCEP to define healthy or desirable levels and not merely levels outside of a certain concentration range defined statistically.

The NCEP has not defined desirable and undesirable TG levels for children and adolescents. For adults, the NCEP has defined desirable TG levels as less than 150 mg/dL, mildly elevated levels as 150-199 mg/dL, elevated levels as 200-499 mg/dL, and levels of 500 mg/dL or higher as very high.

At the University of Florida, hypertriglyceridemia in children is defined as TG levels at or above 125 mg/dL. This value of 125 mg/dL is easy to remember and approximates the mean 95th percentile for TGs in boys and girls across childhood and adolescence. Functionally mild hypertriglyceridemia in children is defined in this clinic as TG levels of 125-299 mg/dL, modest hypertriglyceridemia as TG levels of 300-499 mg/dL, marked hypertriglyceridemia as TG levels of 500-999 mg/dL, and massive hypertriglyceridemia as TG levels of 1000 mg/dL or higher. These cutoffs can be used when determining treatment approaches to hypertriglyceridemia. Desirable and undesirable fasting lipid levels in children and adults are listed in Table 3, below.

Table 3. NCEP Lipid Assessments for Children and Adults (Open Table in a new window)

Children (< 20 y)

Desirable level (mg/dL)

Borderline level (mg/dL)

Undesirable level (mg/dL)

TC

< 170

170-199

≥200

LDL-C

< 110

110-129

≥130

HDL-C*

>45

35-45

< 35

TG

< 125

...

≥125

Adults (≥20 y)

Desirable level (mg/dL)

Borderline level (mg/dL)

Undesirable level (mg/dL)

TC

< 200

200-239

≥240

LDL-C§

< 130

130-159

≥160

HDL-C||

≥40

...

< 40

TGs

< 150

150-199

≥200

* This was not established by NCEP; these values were the adult cutpoints used at the time that the pediatric NCEP guidelines were established.

This was not established by NCEP; a TG level of 125 mg/dL approximates the mean 95th percentile for TGs in boys and girls during childhood and adolescence.

In March of 2001, cutoff points for desirable and undesirable cholesterol, HDL-C, and other levels were revised in the Adult Treatment Panel III (ATPIII). [18]

§ The optimal LDL-C concentration is less than 100 mg/dL; in patients with cardiovascular disease or diabetes, the optimal LDL-C level is less than 70 mg/dL.

|| If the HDL-C level is 60 mg/dL or higher, one risk factor for coronary heart disease can be subtracted in adults.


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