title: Life-course risk factor levels and coronary artery calcification. The Cardiovascular Risk in Young Finns Study.
abstract: BACKGROUND
  Risk factors measured in early life have been shown to predict coronary artery calcium (CAC) in adulthood. However, limited data exist on when risk factor profiles of those who develop CAC diverge from those who do not. We investigated the associations of coronary heart disease risk factor trajectories beginning in adolescence and CAC measured at middle-age.
  
  
  METHODS
  CAC was measured among 589 participants aged 39-45years in whom cardiovascular risk factors (serum lipids, blood pressure, body mass index, physical activity, smoking habits, and fruit, vegetable, fish, and butter intake) had been collected in 1980, 1983, 1986, 2001, and 2007 as part of the Cardiovascular Risk in Young Finns Study.
  
  
  RESULTS
  Mean levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol, apolipoprotein B (Apo-B), and systolic blood pressure (SBP) levels across the 27-year period were significantly higher among those with CAC vs. those without. The difference between the groups was 0.25mmol/l (95% confidence interval, 95%CI, 0.079-0.41) for LDL-C, 0.26mmol/l (95%CI 0.080-0.44) for total cholesterol, 0.05mmol/l (95%CI 0.0085-0.091) for Apo-B and 1.92mmHg (95%CI 0.10-3.74) for SBP after adjustment for other risk factors. Those with CAC at age 39-45years had higher serum lipid levels already in adolescence or early adulthood compared with those without CAC, with these differences becoming more pronounced during the life-course.
  
  
  CONCLUSIONS
  Long-time risk factor exposure to higher LDL-C, total cholesterol and Apo-B levels already starting in adolescence and higher SBP levels in adulthood is associated with CAC at middle-age.
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland. Electronic address: olli.hartiala@utu.fi.
authors.forename: Olli
authors.initials: O
authors.lastname: Hartiala
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland.
authors.forename: Sami
authors.initials: S
authors.lastname: Kajander
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland.
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
authors.affiliation: Department of Medicine and Division of Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Ukkonen
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland; Department of Medicine and Division of Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
authors.affiliation: Department of Radiology, University of Tampere School of Medicine and Tampere University Hospital, Teiskontie, 33520 Tampere, Finland.
authors.forename: Irina
authors.initials: I
authors.lastname: Rinta-Kiikka
authors.affiliation: Department of Radiology, Kuopio University Hospital, Puijonlaaksontie, 70210 Kuopio, Finland.
authors.forename: Sakari
authors.initials: S
authors.lastname: Kainulainen
authors.affiliation: Department of Clinical Physiology, University of Tampere School of Medicine and Tampere University Hospital, Teiskontie, 33520 Tampere, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Kähönen
authors.affiliation: Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Teiskontie, 33520 Tampere, Finland.
authors.forename: Nina
authors.initials: N
authors.lastname: Hutri-Kähönen
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland and Kuopio University Hospital, Puijonlaaksontie, 70210 Kuopio, Finland.
authors.forename: Tomi
authors.initials: T
authors.lastname: Laitinen
authors.affiliation: Department of Clinical Chemistry, Fimlab Laboratories and University of Tampere School of Medicine, Teiskontie, 33520 Tampere, Finland.
authors.forename: Terho
authors.initials: T
authors.lastname: Lehtimäki
authors.affiliation: Department of Medicine and Division of Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland.
authors.forename: Jorma S A
authors.initials: JS
authors.lastname: Viikari
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Hartiala
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland; Department of Medicine and Division of Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland.
authors.forename: Markus
authors.initials: M
authors.lastname: Juonala
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland.
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu, 20520 Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7005, Australia.
authors.forename: Costan G
authors.initials: CG
authors.lastname: Magnussen
mesh_terms: D000293:Adolescent; D000328:Adult; D001055:Apolipoproteins B / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D061205:Vascular Calcification / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D001055:Apolipoproteins B; D008078:Cholesterol, LDL; D002784:Cholesterol
keywords: Atherosclerosis; Coronary artery calcium; Life-course analysis; Risk factors