Joel Nuotio1, Mervi Oikonen2, Costan G Magnussen3, Jorma S A Viikari4, Nina Hutri-Kähönen5, Antti Jula6, Russell Thomson7, Matthew A Sabin8, Stephen R Daniels9, Olli T Raitakari10, Markus Juonala11. 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.
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: Juha Koskinen; Markus Juonala; Terence Dwyer; Alison Venn; Russell Thomson; Lydia Bazzano; Gerald S Berenson; Matthew A Sabin; Trudy L Burns; Jorma S A Viikari; Jessica G Woo; Elaine M Urbina; Ronald Prineas; Nina Hutri-Kähönen; Alan Sinaiko; David Jacobs; Julia Steinberger; Stephen Daniels; Olli T Raitakari; Costan G Magnussen Journal: Circulation Date: 2017-11-23 Impact factor: 29.690
Authors: S S Iyengar; S N Narasingan; Pramod Gandhi; Navneet Jaipuriar; Asha Mahilmaran; Sachin Patil; Mahesh V Abhyankar; Santosh Revankar Journal: J Family Med Prim Care Date: 2020-08-25
Authors: Matthew K Armstrong; Brooklyn J Fraser; Olli Hartiala; Marie-Jeanne Buscot; Markus Juonala; Feitong Wu; Juha Koskinen; Nina Hutri-Kähönen; Mika Kähönen; Tomi P Laitinen; Terho Lehtimäki; Jorma S A Viikari; Olli T Raitakari; Costan G Magnussen Journal: JAMA Cardiol Date: 2021-06-01 Impact factor: 14.676