Reducing elevated non-HDL-C levels during childhood may prevent early-onset cardiovascular disease | Image credit: © yodiyim – © yodiyim – Stock.adobe.com.

In a recently published study, JAMA Network found that children who resolved dyslipidemic non-high-density lipoprotein cholesterol (non-HDL-C) by adulthood had a similar risk of cardiovascular disease (CVD) events as children who never had dyslipidemia. I discovered that. This suggests that interventions to prevent and reduce elevated non-HDL-C levels may prevent her early CVD.

To determine the association between non-HDL-C conditions and CVD events in childhood and adulthood, researchers pooled personal data from a prospective cohort of six children from the United States and Finland. Mean age at baseline was 10.7 years, recruitment occurred from 1970 to 1996, and final follow-up occurred in 2019.

After all exclusion/inclusion criteria, 5,121 participants were included in the primary analysis. The following information regarding childhood (3–19 years) and adulthood (20 years and older) was collected using standardized questionnaires and testing protocols.

– Total cholesterol and HDL-C levels in fasting samples

– Year

– sex

– smoking habits

– Lipid-lowering drugs

– type 2 diabetes

– blood pressure

– Body Mass Index

Non-HDL-C measurements taken between ages 20 and 40 were used to define non-HDL-C exposure in adulthood. Children’s non-HDL-C levels at each visit were standardized by age and gender. z Scores based on age-related developmental changes. The mean Z-score of each participant’s childhood measurements was calculated relative to a single mean value. z Score for analysis.single average z Adult scores were also calculated using the same method.

During a mean follow-up of 8.9 years after age 40, 147 fatal or nonfatal CVD events occurred among 5121 participants. From childhood to adulthood, 937 (18%) had resolution of dyslipidemia and 252 (5%) persisted. Researchers found that 158 ​​(3%) developed dyslipidemia and 3,774 (74%) had non-HDL-C levels that were “persistently within guideline recommendations.” Stated.

Non-HDL-C in children and adults z The scores were moderately correlated (r = 0.587 [P < .001]). Non-HDL-C in childhood and adults z score was associated with increased risk of fatal or non-fatal CVD events when analyzed separately (HR, 1.42) [95% CI, 1.18-1.70] and 1.50 [95% CI, 1.26-1.78] In case of 1 unit increase z score).

Both as a child and as an adult z Scores were included in the same model, childhood non-HDL-C. z score decreased ((HR, 1.12 [95% CI, 0.89-1.41]), while an adult; z score remained significant (HR, 1.41 [95% CI, 1.14-1.74]).

when both z Non-HDL-C scores and changes z Scores between childhood and adulthood were included in the same model “non-HDL-C in childhood.” z score remained a significant predictor of outcome (HR, 1.58) [95% CI, 1.30-1.92]) incremental change in z score was an additional independent predictor (HR, 1.41; [95% CI, 1.14-1.74]),” the study authors noted.

Participants who developed dyslipidemia had a significantly increased risk of fatal or non-fatal CVD events compared to those with persistently normal non-HDL-C during childhood and adulthood. (HR, 2.17) [95% CI, 1.00-4.69]). Those with non-HDL-C dyslipidemia that persisted from childhood to adulthood had twice the risk (HR, 5.17) [95% CI, 2.80-9.56]).

Overall, the results revealed that individuals with persistent non-HDL-C dyslipidemia from childhood to adulthood are at increased risk of CVD events. The researchers concluded that people whose non-HDL-C dyslipidemia resolved by adulthood shared similar risks as patients with normal HDL-C during childhood and adulthood. Non-HDL-C levels may help prevent early CVD. ”

reference:

Wu F, Jacobs DR, Daniels SR et al. Non-high-density lipoprotein cholesterol levels and cardiovascular disease events from childhood to adulthood. jam. Published online on April 12, 2024. doi:10.1001/jama.2024.4819