期刊
JAMA CARDIOLOGY
卷 6, 期 6, 页码 661-668出版社
AMER MEDICAL ASSOC
DOI: 10.1001/jamacardio.2020.7238
关键词
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资金
- Academy of Finland [322098, 286284, 134309, 126925, 121584, 124282, 129378, 117787, 41071]
- Social Insurance Institution of Finland
- Competitive State Research Financing of the Expert Responsibility area of Kuopio, Tampere and Turku University Hospitals [X51001]
- Juho Vainio Foundation
- Paavo Nurmi Foundation
- Finnish Foundation for Cardiovascular Research
- Finnish Cultural Foundation
- Sigrid Juselius Foundation
- Tampere Tuberculosis Foundation
- Emil Aaltonen Foundation
- Yrjo Jahnsson Foundation
- Diabetes Research Foundation of Finnish Diabetes Association
- EU [755320, 848146]
- European Research Council [742927]
- Tampere University Hospital Supporting Foundation
- National Health and Medical Research Council investigator grant [APP1176494]
- Signe and Ane Gyllenberg Foundation
- European Research Council (ERC) [742927] Funding Source: European Research Council (ERC)
The study shows that elevated non-HDL-C levels at different life stages are associated with coronary atherosclerosis in mid-adulthood, with adolescent non-HDL-C levels showing the strongest association.
Question What is the relative association of non-high-density lipoprotein cholesterol (non-HDL-C) levels in adolescence, young adulthood, and mid-adulthood with coronary artery calcification in mid-adulthood? Findings In this 28-year cohort study of 589 participants, the presence of coronary artery calcification in mid-adulthood was associated with exposure to non-HDL-C in adolescence, young adulthood, and mid-adulthood. However, adolescent non-HDL-C levels showed the strongest association with coronary artery calcification. Meaning The odds for the presence of coronary atherosclerosis attributable to non-HDL-C begins early in life, and greater awareness of the importance of elevated non-HDL-C in adolescence is needed. Importance Elevated non-high-density lipoprotein cholesterol (non-HDL-C) is associated with the presence of coronary artery calcification (CAC), a marker of heart disease in adulthood. However, the relative importance of non-HDL-C levels at specific life stages for CAC remains unclear. Objective To identify the relative association of non-HDL-C measured at distinct life stages (adolescence, young adulthood, mid-adulthood) with the presence of CAC measured in mid-adulthood. Design, Setting, and Participants The Cardiovascular Risk in Young Finns Study is a population-based prospective cohort study that started in 1980 with follow-up over 28 years. Participants from 3 population centers (Kuopio, Tampere, and Turku in Finland) represent a convenience sample drawn from the 3 oldest cohorts at baseline (aged 12-18 years in 1980). Data were collected from September 1980 to August 2008. Analysis began February 2020. Exposures Non-HDL-C levels were measured at 3 life stages including adolescence (aged 12-18 years), young adulthood (aged 21-30 years), and mid-adulthood (aged 33-45 years). Main Outcomes and Measures In 2008, CAC was determined from computed tomography and dichotomized as 0 (no CAC, Agatston score = 0) and 1 (presence of CAC, Agatston score >= 1) for analysis. Using a bayesian relevant life course exposure model, the relative association was determined between non-HDL-C at each life stage and the presence of CAC in mid-adulthood. Results Of 589 participants, 327 (56%) were female. In a model adjusted for year of birth, sex, body mass index, systolic blood pressure, blood glucose level, smoking status, lipid-lowering and antihypertensive medication use, and family history of heart disease, cumulative exposure to non-HDL-C across all life stages was associated with CAC (odds ratio [OR], 1.50; 95% credible interval [CrI], 1.14-1.92). At each life stage, non-HDL-C was associated with CAC and exposure to non-HDL-C during adolescence had the strongest association (adolescence: OR, 1.16; 95% CrI, 1.01-1.46; young adulthood: OR, 1.14; 95% CrI, 1.01-1.43; mid-adulthood: OR, 1.12; 95% CrI, 1.01-1.34). Conclusions and Relevance These data suggest that elevated non-HDL-C levels at all life stages are associated with coronary atherosclerosis in mid-adulthood. However, adolescent non-HDL-C levels showed the strongest association with the presence of CAC in mid-adulthood, and greater awareness of the importance of elevated non-HDL-C in adolescence is needed. This cohort study determines the relative association of non-high-density lipoprotein cholesterol levels at different life stages for the presence of coronary artery calcification in mid-adulthood.
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