Adult dyslipidemia prediction is improved by repeated measurements in childhood and young adulthood. The Cardiovascular Risk in Young Finns Study.

Abstract

BACKGROUND:

Prediction of adult dyslipidemia has been suggested to improve with multiple measurements in childhood or young adulthood, but there is paucity of specific data from longitudinal studies.

METHODS AND RESULTS:

The sample comprised 1912 subjects (54% women) from the Cardiovascular Risk in Young Finns Study who had fasting lipid and lipoprotein measurements collected at three time-points in childhood/young adulthood and had at least one follow-up in later adulthood. Childhood/young adult dyslipidemia was defined as total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) or triglycerides (TG) in the highest quintile, or high-density lipoprotein cholesterol (HDL-C) in the lowest quintile. Adult dyslipidemia was defined according to European cut-points (TC > 5.0 mmol/L, LDL-C >3 mmol/L, Non-HDL-C >3.8 mmol/L, HDL-C <1.0 mmol/L (in men)/<1.2 mmol/L (in women) and TG > 1.7 mmol/L). With the exception of triglycerides, Pearson correlation coefficients for predicting adult levels significantly improved when two lipid or lipoprotein measurements in childhood/young adulthood were compared with one measurement (all P < 0.01). For triglycerides, there was significant improvement only when three measurements were considered (P = 0.004). Two measurements significantly improved prediction of dyslipidemia levels in adulthood for non-HDL-C, LDL-C, HDL-C and TG compared with one measurement (P < 0.05 for improved area-under the receiver-operating characteristic curve). Risk of dyslipidemia in adulthood grew according to the number of times a person had been at risk in childhood.

CONCLUSIONS:

Based on these results, it seems that compared to a single measurement two lipid measures in childhood/early adulthood significantly improve prediction of adult dyslipidemia. A lack of dyslipidemia in childhood does not strongly exclude later development of dyslipidemia. Multiple measurements increase the prediction accuracy, but the incremental prognostic/diagnostic accuracy of especially third measurement is modest.

• Authors: Joel Nuotio, Mervi Oikonen, Costan G Magnussen, Jorma S A Viikari, Nina Hutri-Kähönen, Antti Jula, Russell Thomson, Matthew A Sabin, Stephen R Daniels, Olli T Raitakari, Markus Juonala
• Journal: Atherosclerosis (Atherosclerosis) Vol. 239 Issue 2 Pg. 350-7 (Apr 2015) ISSN: 1879-1484 [Electronic] Ireland
• PMID: 25682034 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Lipids

Topics

• Adolescent
• Adult
• Atherosclerosis (blood, physiopathology)
• Body Mass Index
• Cardiovascular Diseases (blood, physiopathology)
• Child
• Child, Preschool
• Dyslipidemias (blood, physiopathology)
• Female
• Finland
• Humans
• Lipids (blood, chemistry)
• Longitudinal Studies
• Male
• Middle Aged
• Predictive Value of Tests
• Risk Factors
• Young Adult