What question did this study set out to answer?

To examine how age-specific lipid levels and distinct life-course lipid trajectory patterns from childhood to adulthood associate with subclinical atherosclerosis in midlife.

October 5, 2022JAMA Network OpenOpen Access

Associations Between Life-Course Lipid Trajectories and Subclinical Atherosclerosis in Midlife

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Why the study?

Childhood lipid levels are associated with adult subclinical atherosclerosis, but life-course lipid trajectories and their associations with cardiovascular disease risk remain poorly characterized.

Are life-course lipid trajectories from childhood to adulthood associated with subclinical atherosclerosis in midlife?

Population

1201 adults in the Bogalusa Heart Study

Comparison

Discrete life-course lipid trajectory patterns vs corresponding low-stable trajectory groups

Design

Prospective, population-based cohort study

Follow-up

Median 36.8 years

Authors

YYYinkun YanGeneral / Preventive / Lipids SLShengxu LiPediatric Cardiology YLYang LiuMinistry of Education

Discussion

Member takes

Implication

High-stable cholesterol trajectories may flag midlife atherosclerosis risk; extends life-course epidemiology but leaves causal effects open.

Key Points

To examine how age-specific lipid levels and distinct life-course lipid trajectory patterns from childhood to adulthood associate with subclinical atherosclerosis in midlife.
Prospective cohort study of 1201 adults (mean age, 45.7 years; 57.5% women; 32.6% Black, 67.4% White) from the Bogalusa Heart Study with follow-up from 1973 to 2016 (median follow-up, 36.8 years).
Participants underwent 4 to 16 serial measurements of total cholesterol, non-HDL-C, LDL-C, HDL-C, and triglycerides from childhood to adulthood, with carotid intima-media thickness assessed in midlife.
Latent mixture modeling was applied to identify discrete life-course lipid trajectory patterns between ages 5 and 45 years.
Lipid levels at every age from 5 to 45 years significantly associated with adult carotid intima-media thickness, with non-HDL-C (age 5 years: β, 0.040 [95% CI, 0.025–0.055]; age 45 years: β, 0.049 [95% CI, 0.026–0.072]) and LDL-C showing the strongest associations.
Compared with the low-stable trajectory group, mean carotid intima-media thickness was significantly higher in the high-stable total cholesterol group (mean difference, 0.152 mm; 95% CI, 0.059–0.244 mm) and the low-rapid increase LDL-C group (mean difference, 0.104 mm; 95% CI, 0.056–0.151 mm).
Significantly higher carotid intima-media thickness was also observed in adverse trajectories for non-HDL-C and triglycerides (moderate-stable group: mean difference, 0.071 mm; 95% CI, 0.019–0.122 mm), whereas no significant differences were observed across HDL-C trajectories.

Structured PICO

Are life-course lipid trajectories from childhood to adulthood associated with subclinical atherosclerosis in midlife?

Population

1201 adults (mean age 45.7 years, 57.5% women, 32.6% Black, 67.4% White) from the Bogalusa Heart Study, a prospective, population-based cohort in a semirural, biracial community in Bogalusa, Louisiana.

Intervention

Life-course lipid trajectories (total cholesterol, non-HDL-C, LDL-C, HDL-C, and triglycerides) from childhood to midlife based on 4 to 16 repeated measurements.

Comparator

Low-stable lipid trajectory groups for each respective lipid.

Outcome

Subclinical atherosclerosis measured by adult carotid intima-media thickness (IMT).surrogate

Discrete life-course lipid trajectories from childhood to midlife are significantly associated with the development of subclinical atherosclerosis, emphasizing the importance of maintaining optimal lipid levels across the lifespan.

Cite This Study

Yan et al. (2022) studied this question.

synapsesocial.com/papers/6a0fea54d13714ec96fecf40 https://doi.org/10.1001/jamanetworkopen.2022.34862

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Implication

High-stable cholesterol trajectories may flag midlife atherosclerosis risk; extends life-course epidemiology but leaves causal effects open.

Associations Between Life-Course Lipid Trajectories and Subclinical Atherosclerosis in Midlife

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Associations Between Life-Course Lipid Trajectories and Subclinical Atherosclerosis in Midlife

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider