Association of Non–High-Density Lipoprotein Cholesterol Measured in Adolescence, Young Adulthood, and Mid-Adulthood With Coronary Artery Calcification Measured in Mid-Adulthood

Abstract

IMPORTANCE Elevated non-high-density lipoprotein cholesterol (non-HDL-C) is associated with the presence of coronary artery calcification (CAC), a marker of heart disease in adulthood. However, the relative importance of non-HDL-C levels at specific life stages for CAC remains unclear.OBJECTIVE To identify the relative association of non-HDL-C measured at distinct life stages (adolescence, young adulthood, mid-adulthood) with the presence of CAC measured in mid-adulthood. DESIGN, SETTING, AND PARTICIPANTS The Cardiovascular Risk in Young Finns Study is a population-based prospective cohort study that started in 1980 with follow-up over 28 years. Participants from 3 population centers (Kuopio, Tampere, and Turku in Finland) represent a convenience sample drawn from the 3 oldest cohorts at baseline (aged 12-18 years in 1980). Data were collected from September 1980 to August 2008. Analysis began February 2020.EXPOSURES Non-HDL-C levels were measured at 3 life stages including adolescence (aged 12-18 years), young adulthood (aged 21-30 years), and mid-adulthood (aged 33-45 years). MAIN OUTCOMES AND MEASURESIn 2008, CAC was determined from computed tomography and dichotomized as 0 (no CAC, Agatston score = 0) and 1 (presence of CAC, Agatston score Ն1) for analysis. Using a bayesian relevant life course exposure model, the relative association was determined between non-HDL-C at each life stage and the presence of CAC in mid-adulthood. RESULTSOf 589 participants, 327 (56%) were female. In a model adjusted for year of birth, sex, body mass index, systolic blood pressure, blood glucose level, smoking status, lipid-lowering and antihypertensive medication use, and family history of heart disease, cumulative exposure to non-HDL-C across all life stages was associated with CAC (odds ratio [OR], 1.50; 95% credible interval [CrI], 1.14-1.92). At each life stage, non-HDL-C was associated with CAC and exposure to non-HDL-C during adolescence had the strongest association

Relative Contribution of Blood Pressure in Childhood, Young‐ and Mid‐Adulthood to Large Artery Stiffness in Mid‐Adulthood

“…Adjusting for lifetime‐averaged values for covariates has been applied to other situations incorporating the BRLM approach to life course modeling. 26 , 27 Fourth, because PWV and cD are not available in childhood in the present study, we are unable to establish temporal associations between BP and large artery stiffness. Fifth, we were unable to examine cardiovascular events in our sample.…”

“…The Bayesian relevant life course exposure model (BRLM) 26 , 27 was used to identify the relative contribution of BP measured in childhood, young‐ and mid‐adulthood on arterial stiffness in mid‐adulthood. Full methodological details of the BRLM have been published previously 28 , 29 and details about model formulation and diagnostics are shown in Data S2 and Figures S2 through S4 .…”

“…Missing BP values were interpolated using an individual growth curve model, 27 a multilevel mixed effects model able to deal with repeated measurements and different numbers of individual observations at unequal time intervals (full details are provided in Data S3 ). 30 In this study, the best fitted individual growth curve model of BP (SBP, DBP, PP, and MAP) was one with a quartic age term and the inclusion of sex and height as modifiers.…”

Non-high-density lipoprotein (non-HDL) cholesterol in adolescence as a predictor of atherosclerotic cardiovascular diseases in adulthood

“…This measures all the atherogenic lipoproteins in plasma including apolipoprotein B100-containing cholesterols (VLDL, LDL, IDL, and Lp(a)) as well as apolipoprotein B48-containing lipoproteins (chylomicrons and it remnants) [6,7]. Recent studies have started to embrace the inclusiveness of non-HDL cholesterol levels in estimating the risk of developing ASCVD, especially over the course of a lifetime [5,6,8,9]. This article aims to review the evidence from longitudinal studies on the existing link between non-HDL cholesterol levels in early life with the development of ASCVD in adulthood.…”

A Novel Clinical Five-Risk Factor Panel for Individualized Recurrence Risk Assessment of Patients With Acute Anterior Uveitis

“… 16 HDL is a protective factor in CVD, nonetheless LDL is a risk factor. 17 – 21 MO is correlated with poor prognosis in some types of cancers. 22 , 23 These diseases are characterized by a chronic course, which means the impact of these factors is persistent.…”