Jordan M Albaum1, Sarah Carsley2, Yang Chen3, David W H Dai3, Gerald Lebovic4, Brian W McCrindle5, Jonathon L Maguire6, Patricia C Parkin7, Catherine S Birken8. 1. Pediatrics Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario; Faculty of Medicine, University of Toronto, Toronto, Ontario; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario. 2. Pediatrics Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario. 3. The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, Toronto, Ontario. 4. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, Toronto, Ontario. 5. Faculty of Medicine, University of Toronto, Toronto, Ontario; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario. 6. Faculty of Medicine, University of Toronto, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, Toronto, Ontario. 7. Faculty of Medicine, University of Toronto, Toronto, Ontario; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario. 8. Pediatrics Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario; Faculty of Medicine, University of Toronto, Toronto, Ontario; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario. Electronic address: catherine.birken@sickkids.ca.
Abstract
OBJECTIVES: To examine patterns of non-high-density lipoprotein (HDL) cholesterol in early childhood and identify factors associated with persistent high non-HDL cholesterol in healthy urban children. STUDY DESIGN: We identified all children enrolled in a primary care practice-based research network called TARGet Kids! (The Applied Research Group for Kids) with ≥3 laboratory measurements of non-HDL cholesterol. Latent class growth model analysis was performed to identify distinct trajectory groups for non-HDL cholesterol. Trajectory groups were then categorized into "normal" vs "persistent-high" non-HDL cholesterol based on guideline cut-off values and logistic regression was completed to examine the association between trajectory group and the presence of anthropometric and cardiometabolic risk factors. RESULTS: A total of 608 children met inclusion criteria for the trajectory analysis (median age at enrolment = 18.3, IQR = 27.9 months). Four trajectory groups were identified with 2 groups (n = 451) categorized as normal non-HDL cholesterol and 2 groups (n = 157) as persistent high non-HDL cholesterol. Family history of high cholesterol (OR 2.04, 95% CI 1.27-3.28) was associated significantly with persistent high non-HDL cholesterol, whereas East/Southeast Asian vs European ethnicity (OR 0.33, 95% CI 0.14-0.78), longer breastfeeding duration (OR 0.96, 95% CI 0.93-1.00), and greater birth weight (OR 0.69, 95% CI 0.48-1.00) were associated with lower odds of persistent high non-HDL cholesterol. CONCLUSIONS: Patterns of non-HDL cholesterol are identified during early childhood, and family history of high cholesterol was associated most strongly with persistent high non-HDL cholesterol. Future research should inform the development of a clinical prediction tool for lipids in early childhood to identify children who may benefit from interventions to promote cardiovascular health.
OBJECTIVES: To examine patterns of non-high-density lipoprotein (HDL) cholesterol in early childhood and identify factors associated with persistent high non-HDL cholesterol in healthy urban children. STUDY DESIGN: We identified all children enrolled in a primary care practice-based research network called TARGet Kids! (The Applied Research Group for Kids) with ≥3 laboratory measurements of non-HDL cholesterol. Latent class growth model analysis was performed to identify distinct trajectory groups for non-HDL cholesterol. Trajectory groups were then categorized into "normal" vs "persistent-high" non-HDL cholesterol based on guideline cut-off values and logistic regression was completed to examine the association between trajectory group and the presence of anthropometric and cardiometabolic risk factors. RESULTS: A total of 608 children met inclusion criteria for the trajectory analysis (median age at enrolment = 18.3, IQR = 27.9 months). Four trajectory groups were identified with 2 groups (n = 451) categorized as normal non-HDL cholesterol and 2 groups (n = 157) as persistent high non-HDL cholesterol. Family history of high cholesterol (OR 2.04, 95% CI 1.27-3.28) was associated significantly with persistent high non-HDL cholesterol, whereas East/Southeast Asian vs European ethnicity (OR 0.33, 95% CI 0.14-0.78), longer breastfeeding duration (OR 0.96, 95% CI 0.93-1.00), and greater birth weight (OR 0.69, 95% CI 0.48-1.00) were associated with lower odds of persistent high non-HDL cholesterol. CONCLUSIONS: Patterns of non-HDL cholesterol are identified during early childhood, and family history of high cholesterol was associated most strongly with persistent high non-HDL cholesterol. Future research should inform the development of a clinical prediction tool for lipids in early childhood to identify children who may benefit from interventions to promote cardiovascular health.
Authors: Jaspreet Sandhu; Vanessa De Rubeis; Michelle Cotterchio; Brendan T Smith; Lauren E Griffith; Darren R Brenner; Ayelet Borgida; Steven Gallinger; Sean Cleary; Laura N Anderson Journal: BMC Cancer Date: 2020-02-21 Impact factor: 4.430