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Abstract

Background: Data suggest that the prediction of adult cardiovascular disease using a model comprised entirely of adult non-laboratory based risk factors is equivalent to an approach that additionally incorporates adult lipid measures. We assessed and compared the utility of a risk model based solely on non-laboratory risk factors in adolescence vs. a lipid model based on non-laboratory risk factors + lipids for predicting high-risk carotid intima-media thickness (cIMT) in adulthood. Methods: The study comprised 2,893 participants aged 12-18 years from four longitudinal cohort studies from the United States (Bogalusa Heart Study and the Insulin Study), Australia (Childhood Determinants of Adult Health Study) and Finland (The Cardiovascular Risk in Young Finns Study) and followed into adulthood when cIMT was measured (mean follow-up 23.4 years). Overweight status was defined according to the Cole classification. Hypertension was defined according to the Fourth Report on High Blood Pressure in Children and Adolescents from the National High Blood Pressure Education Program. High-risk plasma lipid levels were defined according to the National Cholesterol Education Program (NCEP) Expert Panel on Cholesterol Levels in Children. High cIMT was defined as a study-specific value ≥90th percentile. Age-and sex were included in each model. Results: In univariate models all risk factors except for borderline high-and high triglycerides in adolescence were associated with high cIMT in adulthood. In multivariable models (RR [95% CI]), male sex (2.7 [2.0-2.6]), pre-hypertension (1.4 [1.0-1.9]), hypertension (1.9 [1.3-2.9]), overweight (2.0 [1.4-2.9]), obesity (3.7 [2.0-7.0]), borderline high LDL-cholesterol (1.6 [1.2-2.2]), high LDL-cholesterol (1.6 [1.1-2.1]) and borderline low HDL-cholesterol (1.4 [1.0-1.8]) remained significant predictors of high cIMT (P always Conclusions: Non-laboratory-based risk factors and lipids measured in adolescence independently predicted preclinical atherosclerosis in young adulthood. The addition of lipid measurements to traditional clinic based risk factor assessment provided a statistically significant but clinically modest improvement on adolescent prediction of high cIMT in adulthood.

Item Type:	Article
Authors/Creators:	Koskinen, J and Juonala, M and Dwyer, T and Venn, A and Thomson, R and Bazzano, L and Berenson, GS and Sabin, MA and Burns, TL and Viikari, JSA and Woo, JG and Urbina, EM and Prineas, R and Hutri-Kahonen, N and Sinaiko, A and Jacobs, D and Steinberger, J and Daniels, S and Raitakari, OT and Magnussen, CG
Keywords:	intima-media thickness, lipids, risk prediction
Journal or Publication Title:	Circulation (Baltimore)
Publisher:	Lippincott Williams & Wilkins
ISSN:	0009-7322
DOI / ID Number:	https://doi.org/10.1161/CIRCULATIONAHA.117.029726
Copyright Information:	Copyright 2018 American Heart Association
Related URLs:	Google Scholar: Venn, A UTAS Profile: Venn, A Google Scholar: Magnussen, CG UTAS Profile: Magnussen, CG
Item Statistics:	View statistics for this item

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