[Five-year follow up of lipid profile in children in the Rivas-Vaciamadrid study]

Tracking of apolipoprotein B levels measured in childhood and adolescence: systematic review and meta-analysis

To quantify the tracking of apolipoprotein B (apoB) levels from childhood and adolescence and compare the tracking of apoB with low-density lipoprotein (LDL) cholesterol, a systematic search of MEDLINE, Embase, Web of Science, and Google Scholar was performed in October 2023 (PROSPERO protocol: CRD42022298663). Cohort studies that measured tracking of apoB from childhood/adolescence (< 19 years) with a minimum follow-up of 1 year, using tracking estimates such as correlation coefficients or tracking coefficients, were eligible. Pooled correlations were estimated using random-effects meta-analysis. Risk of bias was assessed with a review-specific tool. Ten studies of eight unique cohorts involving 4677 participants met the inclusion criteria. Tracking of apoB was observed (pooled r = 0.63; 95% confidence interval [CI] = 0.53-0.71; I2 = 96%) with no significant sources of heterogeneity identified. Data from five cohorts with tracking data for both lipids showed the degree of tracking was similar for apoB (pooled r = 0.59; 95% CI = 0.55-0.63) and LDL cholesterol (pooled r = 0.58; 95% CI = 0.47-0.68). Study risk of bias was moderate, mostly due to attrition and insufficient reporting.

CONCLUSION

ApoB levels track strongly from childhood, but do not surpass LDL cholesterol in this regard. While there is strong evidence that apoB is more effective at predicting ASCVD risk than LDL cholesterol in adults, there is currently insufficient evidence to support its increased utility in pediatric settings. This also applies to tracking data, where more comprehensive data are required.

WHAT IS KNOWN

• Apolipoprotein B is a known cause of atherosclerotic cardiovascular disease. • Apolipoprotein B levels are not typically measured in pediatric settings, where low-density lipoprotein cholesterol remains the primary lipid screening measure.

WHAT IS NEW

• This meta-analysis of 10 studies showed apolipoprotein B levels tracked strongly from childhood but did not exceed low-density lipoprotein cholesterol in this regard. • More comprehensive tracking data are needed to provide sufficient evidence for increased utility of apolipoprotein B in pediatric settings.

[Values of high-density lipoprotein cholesterol in the pediatric population and risk of thrombosis]

INTRODUCTION

There is evidence of the protective effect of high-density lipoprotein (HDL)-cholesterol against atheroma plaque formation and of its role in cholesterol efflux from cells, as well as its anti-oxidative and inflammatory modulating response properties. Low HDL-cholesterol levels have been associated with a prothrombotic state.

OBJECTIVE

To determine the relationship between HDL-cholesterol and lipidic and hemostatic parameters.

PATIENTS AND METHODS

We studied 110 children (50 girls, 60 boys) aged between 6 and 7 years old. Lipid profile, D-dimer, plasminogen activator inhibitor (PAI) and fibrinogen were determined.

RESULTS

The mean values of the studied parameters were as follows: total cholesterol (192.92+/-26.01 mg/dl), HDL-cholesterol (72.87+/-15.69 mg/dl), low-density lipoprotein-cholesterol (109.46+/-23.30 mg/dl), triglycerides (56.24+/-20.35 mg/dl), apolipoprotein B (91.96+/-14.93 mg/dl), apolipoprotein A1 (168.4+/-24.55 mg/dl), lipoprotein(a) logarithm (1.76+/-1.36 mg/dl), plasminogen activator inhibitor-1 logarithm (PAI-1) (3.77+/-3.93 U/ml), D-dimer logarithm (5.53+/-0.49 ng/ml) and fibrinogen (268.61+/-48.59 mg/dl). When the sample was divided into two groups according to HDL-cholesterol levels, children with lower levels showed significantly higher values of total cholesterol/HDL-cholesterol, fibrinogen and PAI. HDL-cholesterol levels were directly and significantly associated with total cholesterol and apolipoprotein A1 and negatively and significantly associated with the total cholesterol/HDL-cholesterol ratio, fibrinogen and PAI.

CONCLUSION

The children studied had high HDL-cholesterol levels, which could be responsible for the high total cholesterol levels. High values of HDL-cholesterol are significantly associated with a reduction in thrombotic risk.

Relación entre el perfil lipídico y el índice de masa corporal. Seguimiento de los 6 a los 11 años. Estudio Rivas-Vaciamadrid

BACKGROUND

To study the relationship between lipid profile and body mass index (BMI) in children after a 5-year follow-up.

METHOD

A total of 281 children were evaluated at the ages of 6 and 11 years. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and apoproteins A1 (Apo A) and B100 (Apo B) were measured. Low-density lipoprotein cholesterol (LDL-C) was determined and the Apo B/Apo A, TC/HDL-C, LDL-C/HDL-C indexes, and the atherogenic index were calculated. BMI was also calculated (BMI 5 kg/m2). Evolution parameters were calculated (EVO 5 value 11 years - value 6 years). Associations between BMI and lipid profile were studied.

RESULTS

The prevalence of obesity (according to the criteria of the International Obesity Task Force) was 4.98 % (6 years) and 16,72 % (11 years). In children who were in the fourth BMI quartile at the age of 11 years, LDL-C/HDL-C and TC/HDL-C levels were significantly higher and than those in children in the first quartile but HDL-C and Apo A levels were lower. A significant positive correlation was found between the evolution of BMI and the four indexes studied and TG, but this correlation was negative for HDL-C and Apo A. The evolution of the indexes was positive in 11-year-old obese children and negative in nonobese children.

CONCLUSIONS

Lipid profile was worse in 11-year-old children in the fourth BMI quartile than in the remaining children. Obese children had higher values of the indexes studied, supporting the importance of obesity as a cardiovascular risk factor.