Armstrong, MK and Fraser, B and Hartiala, O and Buscot, M-J and Juonala, M and Wu, F and Koskinen, J and Hutri-Kahonen, N and Kahonen, M and Laitinen, TP and Lehtimaki, T and Viikari, JSA and Raitakari, OT and Magnussen, CG, Association of non-high-density lipoprotein cholesterol measured in adolescence, young adulthood, and mid-adulthood with coronary artery calcification measured in mid-adulthood, JAMA Cardiology, 6, (6) pp. 661-668. ISSN 2380-6583 (2021) [Refereed Article]
Importance: Elevated non-high-density lipoprotein cholesterol (non-HDL-C) is associated with the presence of coronary artery calcification (CAC), a marker of heart disease in adulthood. However, the relative importance of non-HDL-C levels at specific life stages for CAC remains unclear.
Objective: To identify the relative association of non-HDL-C measured at distinct life stages (adolescence, young adulthood, mid-adulthood) with the presence of CAC measured in mid-adulthood.
Design, setting, and participants: The Cardiovascular Risk in Young Finns Study is a population-based prospective cohort study that started in 1980 with follow-up over 28 years. Participants from 3 population centers (Kuopio, Tampere, and Turku in Finland) represent a convenience sample drawn from the 3 oldest cohorts at baseline (aged 12-18 years in 1980). Data were collected from September 1980 to August 2008. Analysis began February 2020.
Exposures: Non-HDL-C levels were measured at 3 life stages including adolescence (aged 12-18 years), young adulthood (aged 21-30 years), and mid-adulthood (aged 33-45 years).
Main outcomes and measures: In 2008, CAC was determined from computed tomography and dichotomized as 0 (no CAC, Agatston score = 0) and 1 (presence of CAC, Agatston score ≥1) for analysis. Using a bayesian relevant life course exposure model, the relative association was determined between non-HDL-C at each life stage and the presence of CAC in mid-adulthood.
Results: Of 589 participants, 327 (56%) were female. In a model adjusted for year of birth, sex, body mass index, systolic blood pressure, blood glucose level, smoking status, lipid-lowering and 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 and exposure to non-HDL-C during adolescence had the strongest association (adolescence: OR, 1.16; 95% CrI, 1.01-1.46; young adulthood: OR, 1.14; 95% CrI, 1.01-1.43; mid-adulthood: OR, 1.12; 95% CrI, 1.01-1.34).
Conclusions and relevance: These data suggest that 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, and greater awareness of the importance of elevated non-HDL-C in adolescence is needed.
|Item Type:||Refereed Article|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Diagnosis of human diseases and conditions|
|UTAS Author:||Armstrong, MK (Mr Matthew Armstrong)|
|UTAS Author:||Fraser, B (Dr Brooklyn Fraser)|
|UTAS Author:||Buscot, M-J (Dr Marie-Jeanne Buscot)|
|UTAS Author:||Wu, F (Dr Feitong Wu)|
|UTAS Author:||Magnussen, CG (Associate Professor Costan Magnussen)|
|Web of Science® Times Cited:||9|
|Deposited By:||Menzies Institute for Medical Research|
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