Published online May 1, 2008
PEDIATRICS Vol. 121 No. 5 May 2008, pp. 924-929 (doi:10.1542/peds.2007-1472)
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ARTICLE

Usefulness of Childhood Non–High Density Lipoprotein Cholesterol Levels Versus Other Lipoprotein Measures in Predicting Adult Subclinical Atherosclerosis: The Bogalusa Heart Study

Maria G. Frontini, PhDa, Sathanur R. Srinivasan, PhDa, Jihua Xu, MDa, Rong Tang, MD, MScb, M. Gene Bond, PhDa and Gerald S. Berenson, MDa

a Tulane Center for Cardiovascular Health, Department of Epidemiology, Tulane University Health Sciences Center, New Orleans, Louisiana
b Division of Vascular Ultrasound Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina

OBJECTIVE. This study sought to examine the usefulness of childhood non–high-density lipoprotein cholesterol level versus low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, triglyceride level, apolipoprotein B level, apolipoprotein A-I level, total cholesterol/high-density lipoprotein cholesterol ratio, and apolipoprotein B/apolipoprotein A-I ratio in predicting adult excess carotid intima-media thickness, an indicator of subclinical atherosclerosis.

METHODS. This retrospective cohort study included 437 black and white subjects (70% white and 40% male) who participated in the Bogalusa Heart Study as children 5 to 17 years of age and as adults 16 to 19 years later.

RESULTS. In analyses of each lipoprotein measure as a risk factor for predicting excess carotid intima-media thickness in adulthood, non–high-density lipoprotein cholesterol level, low-density lipoprotein cholesterol level, total cholesterol/high-density lipoprotein cholesterol ratio, apolipoprotein B level, and apolipoprotein B/apolipoprotein A-I ratio emerged as significant predictors, with respective odds ratios of 2.60, 2.95, 1.78, 1.44, and 1.69, after adjustment for childhood BMI, systolic blood pressure, other lipoprotein measures, and follow-up years; the odds ratios for high-density lipoprotein cholesterol, triglyceride, and apolipoprotein A-I levels were not significant. Regarding the discriminating value of different childhood lipoprotein measures in predicting excess carotid intima-media thickness in adulthood, analyses of the area under the receiver operating characteristic curve for each lipoprotein measure, adjusted for the aforementioned nonlipoprotein covariates, indicated that the value of 0.65 for the non–high-density lipoprotein cholesterol level was similar in magnitude to those for other lipoprotein measures, with values ranging from 0.62 to 0.66.

CONCLUSIONS. Childhood non–high-density lipoprotein cholesterol levels are as good as other lipoprotein measures in predicting subclinical atherosclerosis in adulthood, which has practical implications for coronary artery disease risk assessment and intervention in pediatric populations.

Key Words: non–high-density lipoprotein cholesterol • lipoprotein measures • childhood • adulthood • carotid intima-media thickness • subclinical atherosclerosis

Abbreviations: CAD—coronary artery disease • HDL—high-density lipoprotein • LDL—low-density lipoprotein • CI—confidence interval • IMT—intima-media thickness

Accepted Sep 6, 2007.


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