Relationship of Apolipoproteins with Subclinical Cardiovascular Risk in Youth

Madeline A. Czeck, Elise F. Northrop, Nicholas G. Evanoff, Donald R. Dengel, Kyle D. Rudser, Aaron S. Kelly, Justin R. Ryder

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


OBJECTIVE: To examine the association of apolipoproteins with arterial stiffness and carotid artery structure in children and adolescents.

STUDY DESIGN: A total of 338 children and adolescents (178 female) with a mean age 13.0 ± 2.8 years were examined. Apolipoproteins (AI, AII, B 100, CII, CIII, and E) were measured via human apolipoprotein magnetic bead panel. Applanation tonometry determined pulse wave velocity and ultrasound imaging measured carotid intima-media thickness. Dual X-ray absorptiometry measured total body fat percent. Linear regression models were adjusted for Tanner stage, sex, and race with further adjustments for body fat percent. Linear regression models also examined the interaction between Tanner stage and apolipoproteins.

RESULTS: There was a significant positive association between pulse wave velocity and apolipoproteins: AI (0.015 m/s/10 μg/mL [CI 0.005-0.026], P = .003), AII (0.036 m/s/10 μg/mL [0.017-0.056], P < .001), B 100 (0.009 m/s/10 μg/mL [0.002-0.016], P = .012), E (0.158 m/s/10 μg/mL [0.080-0.235], P < .001), and CIII:CII (0.033/μg/mL [0.014-0.052], P < .001). After we added body fat percent to the models, pulse wave velocity (PWV) remained positively associated with greater levels of apolipoproteins: AI, AII, B 100, E, and CIII:CII. Both with and without the adjustment for body fat percent, there were no significant associations between any apolipoprotein and carotid intima-media thickness. There were no significant interactions between Tanner stage and apolipoproteins.

CONCLUSIONS: These findings suggest that greater levels of apolipoprotein AII, E, and CIII:CII are associated with increased arterial stiffness in children and adolescents, both with and without adjusting for percent body fat. These specific apolipoproteins may be useful as biomarkers of cardiovascular risk.

Original languageEnglish (US)
Pages (from-to)199-203.e1
JournalJournal of Pediatrics
StatePublished - Dec 2020

Bibliographical note

Funding Information:
Funded by the National Institutes of Health (F32-HL127881 [to J.R.] and R01-HL110957 [to A.K.]) and the National Center for Advancing Translational Sciences of the National Institutes of Health (UL1TR000114 [to J.R.] and UL1TR002494 [to E.N. and K.R.]). A.K. serves as an unpaid consultant for Novo Nordisk, Vivus, and WW (formerly Weight Watchers), and receives donated drug/placebo from Astra Zeneca for an National Institute of Diabetes and Digestive and Kidney Diseases?funded clinical trial. J.R. receives donated drug/placebo from Boehringer Ingelheim for a clinical trial.


  • arterial stiffness
  • arterial structure
  • carotid intima-media thickness
  • pediatrics
  • pulse wave velocity


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