Childhood levels of serum Apolipoproteins B and A-I predict carotid intima-media thickness and brachial endothelial function in adulthood

Objectives The aim of this study was to determine whether apolipoproteins (apo) B and A-I measured in childhood and adolescence predict atherosclerosis in adulthood. Background Exposure to dyslipidemia in childhood predicts the development of atherosclerosis. Apolipoproteins B and A-I might be good markers of atherogenic dyslipidemia, but there is a paucity of information concerning their importance in childhood. Methods Apolipoproteins B and A-I, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides, blood pressure, obesity, insulin, C-reactive protein, and smoking were assessed in 1980 and 2001 among 879 subjects in the Cardiovascular Risk in Young Finns Study ( ages 3 to 18 years at baseline). Carotid artery intima-media thickness (IMT) and brachial artery flow-mediated dilation (FMD) were measured in 2001 at the age of 24 to 39 years. Results In subjects ages 12 to 18 years at baseline, apoB and apoB/apoA-I ratio were directly ( p < 0.001) related and apoA-I was inversely ( p = 0.01) related with adulthood IMT. In subjects ages 3 to 18 years at baseline, apoB ( p = 0.02) and the apoB/apoA- I ratio ( p < 0.001) were inversely related and apoA- I ( p = 0.003) was directly related to adulthood FMD. These relations were not altered when the effects of nonlipid risk factors and adulthood apolipoproteins were taken into account. The apoB/apoA- I ratio measured in adolescence was superior to LDL/HDL ratio (c-values, 0.623 vs. 0.569, p = 0.03) in predicting increased IMT in adulthood ( IMT >= 90th percentile and/ or carotid plaque). Conclusions Apolipoproteins B and A-I measured in children and adolescents reflect a lipoprotein profile predisposing to the development of subclinical atherosclerosis in adulthood. These markers might have value in pediatric lipid risk assessment.