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

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

Author information

1
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. Electronic address: jovanu@utu.fi.
2
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
3
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia.
4
Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.
5
Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland.
6
Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland.
7
Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia.
8
Murdoch Childrens Research Institute, Melbourne, Australia; Royal Children's Hospital and University of Melbourne, Melbourne, Australia.
9
Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA.
10
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; The Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
11
Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland; Murdoch Childrens Research Institute, Melbourne, Australia.

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

[Indexed for MEDLINE]

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