Usefulness of childhood low-density lipoprotein cholesterol level in predicting adult dyslipidemia and other cardiovascular risks. The Bogalusa Heart Study.
OBJECTIVE
To examine the usefulness of childhood low-density lipoprotein cholesterol (LDL-C) measurement for predicting future dyslipidemia and other cardiovascular risk in adulthood.


METHODS
A longitudinal cohort over 15 years was identified from a community study of the natural course of arteriosclerosis: 1169 individuals (34% black), aged 5 to 14 years, were included at initial study.


RESULTS
Levels of lipoprotein variables in childhood were associated with levels in adulthood, more strongly for total cholesterol (r = .4-.6) and LDL-C (r = .4-.6) than for high-density lipoprotein cholesterol (r = .2-.4) and triglycerides (r = .1-.4). In a stepwise multiple regression, the childhood level was most predictive of the adulthood level, followed by change in body mass index (weight in kilograms/height in meters squared) from childhood to adulthood, with explained variability (R2) of .29, .30, .27, and .19 for total cholesterol, LDL-C, high-density lipoprotein cholesterol, and triglycerides, respectively. Adulthood dyslipidemia, as defined by the National Cholesterol Education Program criterion, was best predicted by childhood LDL-C level among other lipoprotein variables. Compared with subjects with acceptable childhood risk (LDL-C level, < 2.84 mmol/L [< 110 md/dL]), those (6%) with high childhood risk (LDL-C level, > or = 3.36 mmol/L [> or = 130 mg/dL]) not only had a higher prevalence of dyslipidemic total cholesterol level (24%, 8.3-fold), LDL-C level (28%, 5.4-fold), triglyceride level (7%, sevenfold) and lower HDL-C level (14%, 2.1-fold), but also had a significantly higher (P < .05) prevalence of obesity (43%, 1.6-fold) and hypertension (19%, 2.4-fold). In addition, if the childhood LDL-C elevation (> 90th percentile) was persistent, the prevalence of adult dyslipidemia would be markedly increased (P < .001).


CONCLUSIONS
Adverse levels of LDL-C in childhood persist over time, progress to adult dyslipidemia, and relate to obesity and hypertension as well. National Cholesterol Education Program guidelines to classify cardiovascular risk on the basis of LDL-C level are helpful in targeting individuals at risk early in life.
Bao
W
W
Tulane National Center for Cardiovascular Health, Tulane School of Public Health and Tropical Medicine, New Orleans, La., USA.
Srinivasan
S R
SR
Wattigney
W A
WA
Bao
W
W
Berenson
G S
GS
D000293:Adolescent; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL