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

Atherosclerosis. 2015 Apr;239(2):350-7. doi: 10.1016/j.atherosclerosis.2015.02.004. Epub 2015 Feb 7.

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.

Keywords: Atherosclerosis; Follow-up studies; Lipids; Risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

  • Lipids