BACKGROUND: Elevated non–high-density lipoprotein cholesterol (HDL-C) levels are used to identify children at increased cardiovascular risk, but the use of non–HDL-C in childhood to predict atherosclerosis is unclear. We examined whether the National Heart, Lung, and Blood Institute classification of youth non–HDL-C status predicts high common carotid artery intima-media thickness in adulthood. METHODS: We analyzed data from 4 prospective cohorts among 4582 children aged 3 to 19 years who were remeasured as adults (mean follow-up of 26 years). Non–HDL-C status in youth and adulthood was classified according to cut points of the National Heart, Lung, and Blood Institute and the National Cholesterol Education Program Adult Treatment Panel III. High carotid intima-media thickness (cIMT) in adulthood was defined as at or above the study visit-, age-, sex-, race-, and cohort-specific 90th percentile of intima-media thickness. RESULTS: In a log-binomial regression analysis adjusted with age at baseline, sex, cohort, length of follow-up, baseline BMI, and systolic blood pressure, children with dyslipidemic non–HDL-C were at increased risk of high cIMT in adulthood (relative risk [RR], 1.29; 95% confidence interval [CI], 1.07–1.55). Compared with the persistent normal group, the persistent dyslipidemia group (RR, 1.80; 95% CI, 1.37–2.37) and incident dyslipidemia (normal to dyslipidemia) groups (RR, 1.45; 95% CI, 1.07–1.96) had increased risk of high cIMT in adulthood, but the risk was attenuated for the resolution (dyslipidemia to normal) group (RR, 1.17; 95% CI, 0.97–1.41). CONCLUSIONS: Dyslipidemic non–HDL-C levels predict youth at risk for developing high cIMT in adulthood. Those who resolve their non–HDL-C dyslipidemia by adulthood have normalized risk of developing high cIMT in adulthood.
Bibliographical noteFunding Information:
FUNDING: Supported by a grant from the National Institutes of Health and National Heart, Lung, and Blood Institute (R01 HL121230) and the Australian National Health and Medical Research Council Project (grant APP1098369). Dr Magnussen was supported by a National Heart Foundation of Australia Future Leader Fellowship (100849). The Cardiovascular Risk in Young Finns Study has been financially supported by the Academy of Finland (grants 126925, 121584, 124282, 129378, 117787, and 41071); the Social Insurance Institution of Finland; Kuopio, Tampere, and Turku University Hospital medical funds; the Juho Vainio Foundation; the Paavo Nurmi Foundation; the Finnish Foundation of Cardiovascular Research; the Finnish Cultural Foundation; the Sigrid Juselius Foundation; and the Yrjö Jahnsson Foundation. The Childhood Determinants of Adult Health baseline study received grant support from the Commonwealth Departments of Sport, Recreation, and Tourism and Health; The National Heart Foundation; and the Commonwealth Schools Commission. The Childhood Determinants of Adult Health follow-up study received grant support from the National Health and Medical Research Council (APP211316), the National Heart Foundation (GOOH 0578), the Tasmanian Community Fund (D0013808), and Veolia Environmental Services. Sponsors included Sanitarium, ASICS, and Target. Funding bodies and sponsors did not play a role in the study design; collection, analysis, and interpretation of data; writing of the manuscript; or the decision to submit the manuscript for publication. Funded by the National Institutes of Health (NIH).
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