Significance of lipids, lipoproteins, and apolipoproteins during the first 14–16 months of life

Abstract

Background and Aims The aims of this study were to investigate lipid parameters during the first 14–16 months of life, to identify influential factors, and to test whether high concentrations at birth predict high concentrations at 2- and 14–16 months. Methods The Copenhagen Baby Heart Study, including 13,354 umbilical cord blood samples and parallel venous blood samples from children and parents at birth (n = 444), 2 months (n = 364), and 14–16 months (n = 168), was used. Results Concentrations of lipids, lipoproteins, and apolipoproteins in umbilical cord blood samples correlated highly with venous blood samples from newborns. Concentrations of low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein (HDL) cholesterol, apolipoprotein B, and lipoprotein(a) increased stepwise from birth to 2 months to 14–16 months. Linear mixed models showed that concentrations of LDL cholesterol, non-HDL cholesterol, and lipoprotein(a) above the 80th percentile at birth were associated with significantly higher concentrations at 2 and 14–16 months. Finally, lipid concentrations differed according to sex, gestational age, birth weight, breastfeeding, and parental lipid concentrations. Conclusions Lipid parameters changed during the first 14–16 months of life, and sex, gestational age, birth weight, breastfeeding, and high parental concentrations influenced concentrations. Children with high concentrations of atherogenic lipid traits at birth had higher concentrations at 2 and 14–16 months. These findings increase our knowledge of how lipid traits develop over the first 14–16 months of life and may help in deciding the optimal child age for universal familial hypercholesterolaemia screening.

It is Time to Screen for Homozygous Familial Hypercholesterolemia in the United States

“…LDL-C and apoB distribution curves by the same assays support candidacy for newborn screening [30]. A pilot study screening newborns for HeFH in the Czech Republic 3 testing LDL-cholesterol levels on cord blood with reflex genetic testing is underway, a screening program in Germany is measuring total cholesterol levels in newborns and lipid distributions from birth to early in the second year of life in Denmark have been published [31]. These are important first steps towards validation and implementation of a newborn screening test for the identification of newborns with HoFH.…”

Lipoprotein(a) in children and adolescents with genetically confirmed familial hypercholesterolemia followed up at a specialized lipid clinic

“…These results are partly supported by findings from de Boer et al, that showed a mean increase in Lp(a) level of 43 % in children on statin medication, but the increase was lower (22 %) in children without statin medication [ 14 ], however the number of children without lipid-lowering medication in our study was low. Other studies in healthy subjects have also suggested that Lp(a) increases with age, already around the first year of life [ 38 ], in children and adolescents [ 28 ], and during adulthood [ 17 , 24 ]. Most of the studies mentioned however, are cross-sectional, including only one Lp(a) measurement per person, whereas we assessed two Lp(a) levels within the same subject.…”

Measuring lipoprotein(a) for cardiovascular disease prevention – in whom and when?

“…As lipoprotein(a) levels are 80-90% genetically determined, it is of significant interest at what age adult lipoprotein(a) levels are reached and the role of lipoprotein(a) in childhood. Data from the Copenhagen Baby Heart cohort (N ¼ 13 354) indicate that infant levels reach adult levels already at 14-16 months [55 ]. Taken together, lipoprotein(a) is a causal risk factor for ASCVD across age, sex, ethnicity, and comorbidities such as systemic low-grade inflammation, prompting a search for treatment options for the estimated nearly 2 billion individuals worldwide with elevated lipoprotein(a).…”