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A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Variability in Lipid Profiles During Young Adulthood and the Risk of Coronary Artery Calcium Incidence in Midlife:
Jing-Wei Gao1, Qing-Yun Hao2, Ying Lin3
1Department of Cardiology (J.-W.G., Z.-G.H., H.-F.Z., Y.-B.W., Z.-C.X., S.Y., J.-F.W., P.-M.L.) Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Insights
Lipid profile variability in early adulthood predicts coronary artery calcium (CAC) incidence. High variability and high mean levels of LDL-C and non-HDL-C increase CAC risk, emphasizing consistent lipid management.
Area of Science:
- Cardiovascular Disease Epidemiology
- Lipid Metabolism Research
- Preventive Cardiology
Background:
- Intraindividual variability in lipid profiles is a recognized predictor of cardiovascular events.
- The impact of early adulthood lipid variability and mean levels on future coronary artery calcium (CAC) incidence is not well understood.
Purpose of the Study:
- To investigate the association between lipid profile variability in early adulthood and the incidence of CAC in midlife.
- To determine if lipid variability, independent of mean levels, influences CAC development.
Main Methods:
- Analysis of 2395 participants from the CARDIA study with initial CAC=0.
- Calculation of mean lipid levels and variability (total cholesterol, LDL-C, non-HDL-C, triglycerides) from serial measurements.
- Assessment of CAC incidence over a mean 9.0-year follow-up period.
Main Results:
- Higher mean levels of total cholesterol, LDL-C, and non-HDL-C were linked to increased CAC incidence.
- Increased lipid variability (LDL-C, non-HDL-C, triglycerides) was associated with a higher risk of CAC incidence.
- The combination of high lipid levels and high variability posed the greatest risk, with elevated LDL-C variability increasing risk even at low mean levels.
Conclusions:
- Elevated LDL-C and non-HDL-C variability in young adulthood is associated with increased midlife CAC incidence, particularly with high mean atherogenic lipoprotein levels.
- Consistent maintenance of low atherogenic lipid levels throughout early adulthood is crucial for reducing subclinical atherosclerosis.
Background:
Intraindividual variability in lipid profiles is recognized as a potential predictor of cardiovascular events. However, the influence of early adulthood lipid profile variability along with mean lipid levels on future coronary artery calcium (CAC) incidence remains unclear.
Methods:
A total of 2395 participants (41.6% men; mean±SD age, 40.2±3.6 years) with initial CAC =0 from the CARDIA study (Coronary Artery Risk Development in Young Adults) were included. Serial lipid measurements were obtained to calculate mean levels and variability of total cholesterol, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and triglycerides. CAC incidence was defined as CAC >0 at follow-up.
Results:
During a mean follow-up of 9.0 years, 534 individuals (22.3%) exhibited CAC incidence. Higher mean levels of total cholesterol, LDL-C, and non-HDL-C were associated with a greater risk of future CAC incidence. Similarly, 1-SD increment of lipid variability, as assessed by variability independent of the mean, was associated with an increased risk of CAC incidence (LDL-C: hazard ratio, 1.139 [95% CI, 1.048-1.238]; P=0.002; non-HDL-C: hazard ratio, 1.102 [95% CI, 1.014-1.198]; P=0.022; and triglycerides: hazard ratio, 1.480 [95% CI, 1.384-1.582]; P<0.001). Combination analyses demonstrated that participants with both high lipid levels and high variability in lipid profiles (LDL-C and non-HDL-C) faced the greatest risk of CAC incidence. Specifically, elevated variability of LDL-C was associated with an additional risk of CAC incidence even in low mean levels of LDL-C (hazard ratio, 1.396 [95% CI, 1.106-1.763]; P=0.005). These findings remained robust across a series of sensitivity and subgroup analyses.
Conclusions:
Elevated variability in LDL-C and non-HDL-C during young adulthood was associated with an increased risk of CAC incidence in midlife, especially among those with high mean levels of atherogenic lipoproteins. These findings highlight the importance of maintaining consistently low levels of atherogenic lipids throughout early adulthood to reduce subclinical atherosclerosis in midlife.
Registration:
URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005130.
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