title: Associations of retrospective and concurrent lipid levels with subclinical atherosclerosis prediction after 20 years of follow-up: the Coronary Artery Risk Development in Young Adults (CARDIA) study.
abstract: OBJECTIVE
  Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, we sought to determine how well lipids measured at baseline and at 20 years predict the presence of subclinical atherosclerosis.
  
  
  METHODS
  Complete risk factor, coronary artery calcification (CAC), and carotid intima media thickness (CIMT) data were available for 2435 participants. Lipids were categorized into quartiles, CAC at Y20 was dichotomized as present/absent, and CIMT was dichotomized as ≥84 or <84th overall percentile. Multivariable logistic regression was used to model the association between lipids and CAC/CIMT. C statistics were used to assess the discriminative value of each lipid measure in predicting the presence of CAC or CIMT at Y20.
  
  
  RESULTS
  Lipid levels measured in young adulthood as well as middle age were both associated with subclinical disease in middle age. The discriminatory value of lipids was virtually identical at baseline, when participants were 18-30 years of age, and 20 years later. Neither baseline nor Y20 lipid data were strong predictors of Y20 subclinical disease despite statistically significant associations.
  
  
  CONCLUSIONS
  These results are consistent with a growing body of evidence that early-life exposure to nonoptimal lipids matters and lifestyle modifications administered earlier in the lifespan could slow the progress of the atherosclerotic plaques.
authors.affiliation: Division of Academic General Pediatrics, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55414, USA. rayno007@umn.edu
authors.forename: Lewis A
authors.initials: LA
authors.lastname: Raynor
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schreiner
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Loria
authors.forename: J Jeffrey
authors.initials: JJ
authors.lastname: Carr
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Pletcher
authors.forename: James M
authors.initials: JM
authors.lastname: Shikany
mesh_terms: D000293:Adolescent; D000328:Adult; D050197:Atherosclerosis / Q000097:blood / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000000981:diagnostic imaging; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002784:Cholesterol / Q000097:blood*; D016001:Confidence Intervals; D005500:Follow-Up Studies; D006801:Humans; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D014463:Ultrasonography; D014481:United States; D055815:Young Adult
chemical_list: D014280:Triglycerides; D002784:Cholesterol
keywords: Atherosclerosis; Lipids; Risk
references.citation: Circulation. 2002 Dec 17;106(25):3143-421
references.pmid: 12485966
references.citation: JAMA. 2012 Jan 18;307(3):257-8
references.pmid: 22174386
references.citation: J Am Coll Cardiol. 1996 Feb;27(2):277-84
references.pmid: 8557894
references.citation: Pediatrics. 2011 Dec;128 Suppl 5:S213-56
references.pmid: 22084329
references.citation: Pediatrics. 2012 Aug;130(2):353-6
references.pmid: 22826573
references.citation: Pediatrics. 2012 Aug;130(2):349-52
references.pmid: 22826571
references.citation: JAMA. 2003 Nov 5;290(17):2271-6
references.pmid: 14600185
references.citation: J Chronic Dis. 1983;36(9):647-60
references.pmid: 6619260
references.citation: JAMA. 2001 May 16;285(19):2486-97
references.pmid: 11368702
references.citation: JAMA. 2000 Jul 19;284(3):311-8
references.pmid: 10891962
references.citation: JAMA. 2003 Nov 5;290(17):2277-83
references.pmid: 14600186
references.citation: Radiology. 2005 Jan;234(1):35-43
references.pmid: 15618373
references.citation: J Clin Epidemiol. 1988;41(11):1105-16
references.pmid: 3204420
references.citation: Circulation. 1978 Oct;58(4):626-34
references.pmid: 688572
references.citation: Circulation. 2001 Dec 4;104(23):2815-9
references.pmid: 11733400
references.citation: Clin Chem. 1972 Jun;18(6):499-502
references.pmid: 4337382
references.citation: Circulation. 2013 Jan 1;127(1):e6-e245
references.pmid: 23239837
references.citation: J Am Coll Cardiol. 1990 Mar 15;15(4):827-32
references.pmid: 2407762
references.citation: Hypertension. 2009 Nov;54(5):919-50
references.pmid: 19729599
references.citation: Heart. 2012 Feb;98(3):177-84
references.pmid: 22095617
references.citation: J Am Coll Cardiol. 2007 May 22;49(20):2013-20
references.pmid: 17512357
references.citation: Circulation. 2008 Mar 4;117(9):1216-27
references.pmid: 18316498
references.citation: Biometrics. 1988 Sep;44(3):837-45
references.pmid: 3203132
references.citation: Ann Intern Med. 2010 Aug 3;153(3):137-46
references.pmid: 20679558