Key result
Adolescent non-HDL-C tracks into adulthood, predicting ~0.8 mmol/L higher levels per 1 mmol/L increase.
Cohort (n=2,182)
No
Non-HDL-C demonstrates moderate stability and strong positive association from adolescence into young adulthood, supporting early-life lipid monitoring to inform life-course cardiovascular disease prevention.
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Adolescent non-HDL-C tracking may inform early monitoring; extends prior data but leaves causal CV effects open.
Background Non-high-density lipoprotein cholesterol (non-HDL-C) predicts cardiovascular risk, yet evidence on its long-term tracking from adolescence to adulthood remains limited. This study examined the tracking of non-HDL-C from adolescence to young adulthood and assessed the association between measurements obtained at these two life stages among Iranian population. Methods This prospective cohort study included 2,182 adolescents aged 11–18 years from the Tehran Lipid and Glucose Study, with a median follow-up of 15 years. Participants had at least one non-HDL-C measurement during adolescence and at least one follow-up measurement after 18 years of age. Mixed-effects models were fitted using all available repeated non-HDL-C measurements to estimate individual growth curves. Non-HDL-C was summarized as the area under the curve (AUC), derived from the individual growth curves over the predefined age intervals of 11–18 years and 20–37 years (young adulthood) and divided by the interval length to obtain the average non-HDL-C. Tracking was assessed using Spearman’s correlation coefficients and quintile transition analyses. Multivariable linear regression models were used to examine whether the adolescent non-HDL-C AUC was associated with adult non-HDL-C AUC after controlling for demographic, anthropometric, and cardiometabolic variables. Subgroup analyses were conducted by sex and adult body mass index (BMI) category (normal-weight and overweight/obese). Results Non-HDL-C demonstrated moderate tracking from adolescence to adulthood in the overall population (ρ = 0.55; 95% CI: 0.52–0.58), with within-sex correlations of ρ = 0.67 (0.64–0.70) among females and ρ = 0.63 (0.58–0.67) among males. Overall, 75.5% of adolescents in the highest non-HDL-C quintile (quintile 5) remained in the upper quintiles (quintile 4 or quintile 5) in adulthood. Adolescent non-HDL-C levels were positively associated with adult non-HDL-C levels; each 1 mmol/L higher adolescent average non-HDL-C AUC was associated with a 0.772 mmol/L higher adult average non-HDL-C (95% CI: 0.739–0.806). The association did not differ significantly by sex (P for interaction = 0.677) or adult BMI category (P for interaction = 0.329). Conclusion Non-HDL-C demonstrated moderate tracking from adolescence to young adulthood. These findings indicate relative stability of non-HDL-C across the transition to adulthood and highlight the potential value of understanding lipid patterns from adolescence onward to inform life-course approaches to cardiovascular disease prevention.
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Ramezankhani et al. (2026) conducted a cohort in Dyslipidemia / Cardiovascular risk (non-HDL-cholesterol tracking) (n=2,182). Adolescent non-HDL-cholesterol (average AUC over ages 11-18 years) vs. Lower adolescent non-HDL-cholesterol levels (per 1 mmol/L increment or across quintiles) was evaluated on Young-adult average non-HDL-cholesterol concentration (AUC over ages 20-37 years) and tracking correlation (β 0.772 mmol/L per 1 mmol/L higher adolescent non-HDL-C AUC (Spearman ρ = 0.55), 95% CI 0.739-0.806, p=<0.001). Adolescent non-HDL-C tracked moderately into young adulthood (ρ = 0.55), with each 1 mmol/L increase predicting a 0.772 mmol/L higher adult level (95% CI 0.739-0.806; P<0.001).
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