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Non–HDL-C During Youth and Coronary Artery Calcification in Mid-Life
Quick Takes
- Non–HDL-C in young and middle adulthood is associated with coronary atherosclerosis.
- Non–HDL-C in adolescence showed the strongest association with the presence of CAC in mid-adulthood.
Study Questions:
Are non–high-density lipoprotein cholesterol (non–HDL-C) levels measured during adolescence and young adulthood associated with coronary artery calcification (CAC) in mid-adulthood?
Methods:
Data from the Cardiovascular Risk in Young Finns Study, a population-based prospective cohort study, were used for the present analysis. Participants from three population centers (Kuopio, Tampere, and Turku in Finland) aged 12-18 years in 1980 were included. Data were collected from September 1980 to August 2008. Non–HDL-C levels were measured at three life stages, including adolescence (aged 12-18 years), young adulthood (aged 21-30 years), and mid-adulthood (aged 33-45 years). The primary outcome of interest was CAC measured in 2008. CAC scores were dichotomized as 0 (no CAC, Agatston score = 0) and 1 (presence of CAC, Agatston score ≥1) for analysis.
Results:
A total of 3,596 participants were enrolled in the Cardiovascular Risk in Young Finns Study, of which 711 participants from the oldest birth cohorts were invited to receive a computed tomography scan. A total of 598 participants (56% female) agreed to have CAC scoring, which comprised the study population for the current analysis. After adjustment for birth year, sex, body mass index, systolic blood pressure, blood glucose level, smoking status, lipid lowering, antihypertensive medication use, and family history of heart disease, cumulative exposure to non–HDL-C across all life stages was associated with CAC (odds ratio [OR], 1.50; 95% credible interval [CrI], 1.14-1.92). At each life stage, non–HDL-C was associated with CAC. Exposure to non–HDL-C during adolescence had the strongest association (OR, 1.16; 95% CrI, 1.01-1.46), while associations were also significant for young adulthood (OR, 1.14; 95% CrI, 1.01-1.43) and mid-adulthood (OR, 1.12; 95% CrI, 1.01-1.34).
Conclusions:
The investigators concluded that these data suggest elevated non–HDL-C levels at all life stages are associated with coronary atherosclerosis in mid-adulthood. However, adolescent non–HDL-C levels showed the strongest association with the presence of CAC in mid-adulthood.
Perspective:
These data, although limited by a homogenous cohort, do suggest non–HDL-C at young ages is associated with the development of coronary atherosclerosis in mid-life. These findings support the need for cardiovascular prevention efforts to start early in life.
Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Dyslipidemia, Noninvasive Imaging, Prevention, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Imaging, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Lipid Metabolism, Nonstatins, Computed Tomography, Nuclear Imaging
Keywords: Adolescent, Atherosclerosis, Cholesterol, Cholesterol, HDL, Diagnostic Imaging, Dyslipidemias, Plaque, Atherosclerotic, Primary Prevention, Risk Factors, Tomography, X-Ray Computed
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