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ADOLESCENT LIPOPROTEIN SUBCLASS PROFILE AND CAROTID INTIMA-MEDIA THICKNESS: PROSPECTIVE COHORT STUDY
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.
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.
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).
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.