Sophia Julia Kiechl (Austria)
Medical University of Innsbruck Department of NeurologyAuthor Of 2 Presentations
ADOLESCENT LIPOPROTEIN SUBCLASS PROFILE AND CAROTID INTIMA-MEDIA THICKNESS: PROSPECTIVE COHORT STUDY
Abstract
Background and Aims
Assessment of comprehensive lipoprotein subclass profiles in adolescents and their relation to vascular disease may enhance our understanding of the development of dyslipidemia in early life and inform early vascular prevention.
Methods
Nuclear magnetic resonance was used to measure lipoprotein profiles, including lipids (cholesterol, free cholesterol, triglycerides, phospholipids) and apolipoproteins (apoB-100, apoA1, apoA2) of 17 lipoprotein subclasses (from least dense to densest: VLDL-1 to -6, IDL, LDL-1 to -6, HDL-1 to -4) in n=1776 14- to 19-year olds (56.6% female) and n=3217 25- to 85-year olds (51.5% female), all community-dwelling. Adolescent lipoprotein profiles were related to carotid intima-media thickness (cIMT) as ascertained by sonography.
Results
Adolescents compared to adults had lower triglycerides, total, LDL, and non-HDL cholesterol, and apoB, and higher HDL cholesterol. They showed 27.2 to 60.5% lower triglyceride content of all lipoprotein subclasses and 21.7 to 50.0% lower VLDL lipid content. Concentrations of dense LDL-4 and LDL-5 were 40.7 to 47.3% lower, with markedly lower levels also of LDL-6 and LDL-3, but 24.3% higher HDL-1 ApoA1. In adolescents, LDL-3, LDL-4, and LDL-5 subclasses but not VLDL or HDL were associated with cIMT (difference in cIMT for a 1-SD higher concentration, 4.76 to 5.93μm).
Conclusions
Adolescents showed a markedly different and more favorable lipoprotein profile compared to adults. Dense LDL subclasses were the only subclasses associated with cIMT, implicating them as the potential preferred therapeutic target for primary prevention of cardiovascular disease in adolescents.
HIGH PREVALENCE OF CARDIOVASCULAR RISK FACTORS IN ADOLESCENTS OF THE GENERAL POPULATION
Abstract
Background and Aims
A significant proportion of the burden of non-communicable disease in adults has its roots in adolescence and this is particularly true for cardiovascular disease and stroke. Detection of risk factors, early stages of disease and laboratory abnormalities at young ages may aid disease prevention and management.
Methods
We systematically assessed the frequency of yet unknown medical conditions that require further diagnostic work-up or intervention (life-style counselling or pharmacotherapy) in 2088 adolescents sampled from the general population considering previously diagnosed physician-confirmed diseases. The easy-to-administer health screening included medical history taking, fasting blood analysis, and blood pressure and body measurements, and was performed at schools.
Results
Adolescents were on average 16.4 (SD 1.1) years old and 56.4 percent were female. The health screening newly detected relevant medical conditions in 45.4 [95% CI, 43.3–47.6] percent (55.8 [95% CI, 52.5–59.0] percent in boys and 37.4 [95% CI, 34.6–40.2] percent in girls). The most prevalent previously unknown medical conditions were vascular risk factors like elevated blood pressure (16.7%) and hypertension (10.2%), metabolic syndrome (3.0%), hypercholesterolemia (7.6%) and hypertriglyceridemia (9.6%). On the other hand, impaired fasting glucose and pre-diabetes were rare in this community-based sample of adolescents as were endocrine and other abnormalities (all <1.0%) except for subclinical hypothyroidism (5.7%) and hyperuricemia (7.8%).
Conclusions
Health screening in adolescence has a high diagnostic yield for previously unknown vascular risk factors, is feasible in the school setting, and may provide an opportunity for guideline-recommended targeted prevention in the young.
Presenter of 1 Presentation
HIGH PREVALENCE OF CARDIOVASCULAR RISK FACTORS IN ADOLESCENTS OF THE GENERAL POPULATION
Abstract
Background and Aims
A significant proportion of the burden of non-communicable disease in adults has its roots in adolescence and this is particularly true for cardiovascular disease and stroke. Detection of risk factors, early stages of disease and laboratory abnormalities at young ages may aid disease prevention and management.
Methods
We systematically assessed the frequency of yet unknown medical conditions that require further diagnostic work-up or intervention (life-style counselling or pharmacotherapy) in 2088 adolescents sampled from the general population considering previously diagnosed physician-confirmed diseases. The easy-to-administer health screening included medical history taking, fasting blood analysis, and blood pressure and body measurements, and was performed at schools.
Results
Adolescents were on average 16.4 (SD 1.1) years old and 56.4 percent were female. The health screening newly detected relevant medical conditions in 45.4 [95% CI, 43.3–47.6] percent (55.8 [95% CI, 52.5–59.0] percent in boys and 37.4 [95% CI, 34.6–40.2] percent in girls). The most prevalent previously unknown medical conditions were vascular risk factors like elevated blood pressure (16.7%) and hypertension (10.2%), metabolic syndrome (3.0%), hypercholesterolemia (7.6%) and hypertriglyceridemia (9.6%). On the other hand, impaired fasting glucose and pre-diabetes were rare in this community-based sample of adolescents as were endocrine and other abnormalities (all <1.0%) except for subclinical hypothyroidism (5.7%) and hyperuricemia (7.8%).
Conclusions
Health screening in adolescence has a high diagnostic yield for previously unknown vascular risk factors, is feasible in the school setting, and may provide an opportunity for guideline-recommended targeted prevention in the young.