Blood lipids in young men followed 32 years

Plasma Clusterin and Lipid Profile: A Link with Aging and Cardiovascular Diseases in a Population with a Consistent Number of Centenarians

The role of Clusterin in attenuation of inflammation and reverse cholesterol transfer makes this molecule a potential candidate as a marker for cancer, cardiovascular disease, diabetes mellitus, and metabolic syndrome. In elderly subjects cardiovascular diseases represent the primary cause of death and different clinical studies have shown a positive correlation of these diseases with changes in the lipid pattern. This work aimed at evaluating the relationship between circulating clusterin and the biochemical parameters that characterize the lipid profile of a Sardinian population divided into five age groups including centenarians; the high frequency in Sardinia of these long-lived individuals gave us the opportunity to extend the range of the age groups to be analyzed to older ages and to better evaluate the changes in the lipid balance during ageing and its relationship with clusterin concentration in plasma. Our results showed that Clusterin concentration values of the youngest group were more similar with the centenarian's group compared to the other age groups, and a positive correlation arises with LDL. Furthermore given the high prevalence of cardiovascular diseases in the population examined and the association of Clusterin with these pathologies we evaluated Clusterin concentration variation in two groups with or without cardiovascular diseases. In presence of cardiovascular disease, Clusterin is significantly related to the most atherogenic components of lipid profile (total cholesterol and LDL), especially in women, suggesting its potential role in modulating cardiovascular metabolic risk factors.

Aging and dyslipidemia: a review of potential mechanisms

Elderly adults constitute a rapidly growing part of the global population, thus resulting in an increase in morbidity and mortality related to cardiovascular disease (CVD), which remains the major cause of death in elderly population, including men and women. Dyslipidemia is a well-established risk factor for CVD and is estimated to account for more than half of the worldwide cases of coronary artery disease (CAD). Many studies have shown a strong correlation between serum cholesterol levels and risk of developing CAD. In this paper, we review the changes of plasma lipids that occur in men and women during aging and the potential mechanisms of age-related disorders of lipoprotein metabolism covering humans and/or animals, in which changes of the liver sinusoidal endothelium, postprandial lipemia, insulin resistance induced by free fatty acid (FFA), growth hormone (GH), androgen (only for men) and expression and activity of peroxisome proliferator-activated receptor α (PPARα) are mainly focused.

Childhood obesity in Canada: a review of prevalence estimates and risk factors for cardiovascular diseases and type 2 diabetes

Childhood obesity in Canada has become increasingly prevalent over the past 2 decades. Despite inconsistencies regarding different anthropometric indicators, cut-offs, and reference populations, both regional and national investigations have revealed high numbers of overweight and obese children and adolescents. A number of risk factors and health consequences have been associated with increased levels of body fatness in youth. Specifically, risk factors for cardiovascular diseases (CVD) and type 2 diabetes are known to develop early in life and tend to emerge in clusters among overweight youngsters. Unhealthy lifestyle behaviours (i.e., physical inactivity), a genetic disposition, and a centralized body fat distribution, all contribute to increased risk. In order to prevent future generations of children from experiencing increased morbidity and mortality as overweight and obese adults, coordinated efforts at all levels (family, school, community, and government) must be established with a long-term commitment to promote healthy nutrition and physical activity behaviours in our youth.

Indices of adipose tissue distribution, apolipoproteins B and AI, lipoprotein (a), and triglyceride concentration in children aged 4-11 years: the Third National Health and Nutrition Examination Survey

This study examined the association of body fat distribution with serum apolipoproteins, lipoprotein (a), and triglyceride, risk factors for cardiovascular morbidity, in a representative sample of U.S. black, white, and Hispanic children. Data from the Third National Health and Nutrition Examination Survey for children aged 4-11 years revealed the mean waist-to-hip ratio (WHR) varied consistently with age, gender, and ethnic group. Levels were highest in Mexican Americans. WHR showed significant negative associations with apo AI concentration and positive associations with apo B and the ratio of apo B to apo AI independent of age but not body mass index (BMI). Associations of WHR with serum triglyceride concentration were independent of age and BMI. Other indices of body fat distribution were not superior to WHR. Lp (a) was not consistently associated with WHR. In conclusion, after controlling for BMI and age, body fat distribution was not significantly associated with apo AI and apo B with few exceptions. Nor was Lp (a) significantly associated with body fat distribution. Casual serum triglyceride levels were significantly positively associated with WHR independent of age and BMI in non-Hispanic white and Mexican American children.

Risk of breast cancer in relation to anthropometry, blood pressure, blood lipids and glucose metabolism: a prospective study within the Malmö Preventive Project

Insulin resistance may be a risk factor for breast cancer, possibly through increased levels of oestrogens or insulin-like growth factor I. Insulin resistance has been associated with obesity, hypertension, dyslipidaemia and impaired glucose tolerance. We studied the relation of these factors to breast cancer risk in a prospective cohort study of 9738 women. Menopausal status was defined a priori, and 112 cases of invasive breast carcinoma occurred in women who were premenopausal at baseline and 157 cases in subjects who were peri/postmenopausal. Relative risks (RR) for breast cancer were calculated by Cox's proportional hazards analysis for different quartiles of height, weight, body mass index, blood pressure, pulse rate and serum levels of total cholesterol, triglycerides, fasting blood glucose and glucose at 120 min after an oral dose of glucose. Peri/postmenopausal women had a significantly increased age-adjusted relative risk of breast cancer associated with height (RR = 1.78 for the highest versus lowest quartile), and the RR was increased over quartiles of cholesterol levels (P-value for trend: 0.05). No other significant associations were found. Adjustments for potential confounding factors or restriction of the analysis to cases and person-years before 55 years of age (premenopausal women), or after 55 years (peri/postmenopausal women), did not change

Changes in patterns of fatness in adult men in relation to serum indices of cardiovascular risk: the Normative Aging Study

BACKGROUND

Overweight and/or excessive weight gain, as well as changes in central fat deposition, have been implicated in increased incidence of coronary disease and type 2 diabetes.

OBJECTIVE

We related adiposity (BMI, kg/m2, and waist circumference, WC, cm) to biochemical risk factors (cholesterol, triglyceride and glucose concentrations) for cardiovascular disease and diabetes.

DESIGN

Associations were examined both cross-sectionally and longitudinally, among 867 men enrolled in the Normative Aging Study (NAS). We included all participants with complete anthropometric and clinical data at both enrollment (average age 45 y) and after approximately 15 y of follow-up (average age 60 y). We used multiple linear regression analysis to test relationships between body fatness and change in body fatness and the biochemical indices.

RESULTS

In adulthood, concurrent BMI and waist circumference related significantly to triglyceride and glucose concentrations and to 2 h glucose responses at two time points. Measures of fatness 15 y earlier were also predictive of later triglyceride and glucose measures. When included together, BMI, but not WC, remained independently associated with triglycerides at both time points, while WC, but not BMI, remained significantly associated with fasting glucose concentrations and glucose response at the follow-up observation. In contrast, gains in weight and abdominal fat from entry to follow-up related more strongly to serum cholesterol concentrations than did concurrent measures.

CONCLUSION

Attained weight, weight gain, and location of weight contribute differentially to these indices of cardiovascular and diabetes risk.

Longitudinal trends in total serum cholesterol levels in a Japanese cohort, 1958-1986

The 28-year follow-up of a Japanese cohort, having collected vast amounts of data collected on total serum cholesterol (TC), provided an exceptional opportunity to examine TC temporal trends. The longitudinal statistical method of growth-curve analysis was used to elucidate the age-related changes in TC levels and to characterize these trends in relation to sex, birth cohort, time period, place of residence, and body mass index (BMI). Japanese TC levels at initial examination were remarkably lower than those in western countries. During the study period from 1958 to 1986, TC levels increased dramatically with age in both sexes. The slope of the cholesterol growth curve was steeper for women than for men, with the difference growing larger after age 40 years. Drastic changes in Japanese behavior and lifestyle, especially westernization of the diet, are thought to have affected the TC values as time-period effects. As a result of this temporal change, which affected different cohorts at different ages, TC values were higher in members of the younger cohort. The increase of the TC values as time-period effects were larger in earlier period than in later period. These time-period effects appeared to be almost similar in men and women. The TC growth curves also varied by city of residence. Subjects in urban areas had higher TC values than subjects in rural areas. Changes associated with BMI from 1958 to 1986 were only partially responsible for the increased steepness of the TC growth curve.

Different effects of hypertension and hypercholesterolemia on the natural history of aortic atherosclerosis by the stage of intimal lesions

To investigate the histopathologic modes of the effect of hypertension and hypercholesterolemia on atherosclerosis progression, a total of 573 male autopsied aortas, ranging from 0 to 97 years-old, were histomorphometrically compared by the status based on antemortem risk factors. Specimens were classified into four categories according to the criteria reported by the American Heart Association after histometric measurement at defined sites of the aortas. Intimal lesions progressed in the same fashion in all the risk factor groups examined; normal intima converted to fatty streak, preatheroma (characterized by microscopic extracellular lipid deposition) and then atheroma. This progression of intimal lesions correlated with age-related increases in intimal thickness independent of risk factors. Although the frequency of fatty streaks and the population of foam cells were greater in the hypercholesterolemics than in the non-risk patients, the frequencies of preatheroma and atheroma were not different between these two patient groups until patients reached the fifth decade. In contrast, the frequencies of preatheroma and atheroma were consistently greater in the hypertensives than in the other groups by the fifth decade. Hypertension was also related to intimal thickness in the younger groups. Our findings suggest that hypertension and hypercholesterolemia affect the progression of atherosclerosis differently by histopathologic stages.

Influence of apolipoprotein E polymorphism on the tracking of childhood levels of serum lipids and apolipoproteins over a 6-year period. The Bogalusa Heart Study

The influence of apolipoprotein (apo) E polymorphism on the tracking of serum lipoprotein variables over a 6-year follow-up period was examined in 442 individuals aged 5-15 years at baseline. The apo E phenotype-specific differences in total cholesterol and low-density lipoprotein (LDL) cholesterol levels persisted in the study cohort at baseline and follow-up examinations. However, the correlations of baseline versus follow-up levels of total cholesterol and LDL cholesterol varied according to the apo E phenotype group, with the apo E2 group, carrying E2/2 and E3/2 phenotypes, showing highest correlation for these variables (r = 0.73 - 0.74) and the apo E4 carrying E3/4 and E4/4 phenotypes the lowest (r = 0.48 - 0.59). The tracking correlation for LDL cholesterol in the apo E2 group was different form that of the other phenotype groups (P < 0.05). In terms of persistence in ranks over time, of the individuals who were in the highest quartile of LDL cholesterol at baseline none of those in the apo E2 group, 63% of those in the apo E3 group carrying E3/3 phenotype, and 60% of those in the apo E4 group maintained this high rank at follow-up; corresponding values for persistence in ranking at the lowest quartile over time were 82% for the apo E2 group, 57% for the apo E3 group, and 33% for the apo E4 group. Further, in a multiple regression model, apo E phenotype was retained as a predictor variable only in the case of LDL cholesterol. Thus, apo E polymorphism influences not only the level of LDL cholesterol in childhood, but also its tracking at least over a 6-year period.

Nongenetic influences of obesity on other cardiovascular disease risk factors: an analysis of identical twins

The importance of genetic influences on obesity has been emphasized recently. We conducted matched co-twin analyses of 250 pairs of White, male, monozygotic twins from the National Heart, Lung, and Blood Institute (NHLBI) Twin Study. Entirely in the absence of genetic influences, obesity was significantly associated with systolic and diastolic blood pressures; one-hour, post-load glucose; total, LDL-, and HDL-cholesterol; and triglycerides among these 42-55 year old men. Similar results were obtained in longitudinal analyses of weight change during adulthood (from mean age of 20 to mean age of 48 years) and risk factor status at middle-age. These results indicate that behaviors and environmental exposures that occur later in life are responsible, at least in part, for the associations between adult obesity and cardiovascular disease risk, supporting the appropriateness of weight reduction efforts during adulthood.

Cholesterol-based personal risk assessment in coronary heart disease

Using data from the National Health and Nutrition Examination Survey (NHANES II) 1976-1980, we demonstrate how cross-sectional total serum cholesterol surveillance data can be used by an individual to assess current and future personal cholesterol risk status. We propose statistical models, based on a person's current measured cholesterol level and the relationship between cross-sectional age and cholesterol percentile estimates, that will allow prediction of future cholesterol levels or the age at which specified cholesterol risk levels will be reached if no cholesterol-altering intervention is taken. These models incorporate the observed variation in the NHANES II data and expected intraperson biological variation and intralaboratory analytical variation. We illustrate the adequacy of the models using data from the longitudinal Framingham Study.

Transitions of cardiovascular risk from adolescence to young adulthood--the Bogalusa Heart Study: II. Alterations in anthropometric blood pressure and serum lipoprotein variables

Cardiovascular (CV) risk factors change over time with the emergence of clinically recognizable abnormalities (obesity, hypertension and hyperlipoproteinemia) in the second and third decades of life. A cohort of 286 subjects, aged 11-15 in 1973-74 were reexamined 6 years later to observe changes in height, weight, blood pressure, lipids and lipoproteins between adolescence and adulthood. During the 6 years of follow-up, 10-11 year-old males increased 30 cm in height and 32 kg in weight. Among 10-11 year-old girls, height increased 12-15 cm and weight increased 15 kg in whites and 20 kg in blacks. Mean systolic BP increased 16-23 mmHg in black males and 11-15 mmHg in white males. Mean serum total cholesterol levels increased with age such that levels in 20 year olds were 160-190 mg/dl, about 10 to 15 mg/dl higher than 18 year olds. In white males beta-lipoprotein cholesterol increased (13 mg/dl) with age; however, there was a simultaneous decrease in alpha-lipoprotein cholesterol (11 mg/dl), resulting in a dramatic rise in the beta-LPC/alpha-LPC ratio. These adverse changes in LPC may be related to the early development of atherosclerosis and risk for coronary heart disease of young white men. Early identification of hypertension and hyperlipoproteinemia should help to predict and prevent future CV disease.

Tracking of high- and low-density-lipoprotein cholesterol from childhood to young adulthood in a single large kindred with familial hypercholesterolemia

Tracking of high- and low-density-lipoprotein cholesterol (HDLC, LDLC) from childhood to young adulthood was assessed in 77 children and in 53 adults from a single large pedigree with familial hypercholesterolemia who were respectively less than or equal to 19 and greater than or equal to 20 years old when first studied in 1973, with reassessment in 1984. No children and only five of the adults had received LDLC lowering therapy from 1973 to 1984. The rank correlations between the 1973 and 1984 measurements for LDLC were 0.73, 0.74, and 0.87; and for HDLC were 0.55, 0.73, and 0.65 (P less than 0.0001 for all correlations), respectively for relatives who were less than or equal to 12, 13 to 19, and greater than or equal to 20 years old in 1973. The 1973:1984 LDLC and HDLC correlations, categorized by relationships to the proband, were as follows: (1) unrelated, LDLC = 0.16, HDLC = 0.56;* (2) first-degree relatives, LDLC = 0.90, HDLC = 0.30; (3) second-degree relatives, LDLC = 0.79, HDLC = 0.39; and (4) other relatives, LDLC = 0.62, HDLC = 0.64. All nine of the probands' first-degree relatives who were above the age-sex specific LDLC 95th percentile in 1973 were also greater than the 95th percentile for LDLC in 1984. Similarly, seven of eight second-degree relatives with LDLC greater than the 95th percentile in 1973 were greater than the 95th percentile in 1984, as were ten of 15 other relatives. LDLC levels in childhood in this extended kindred were highly predictive of adult values.(ABSTRACT TRUNCATED AT 250 WORDS)

Longitudinal serum lipoprotein changes in white males during adolescence: the Bogalusa Heart Study

Determinants of follow-up levels of low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) and the ratio of LDL-C to HDL-C were analyzed in a longitudinal study. White boys (n = 81) aged 11 to 12 years, when examined in 1973-1974 (year 1) were reexamined in 1978-1979 (year 6) at ages 16 to 17 years. During follow-up, mean levels of LDL-C increased from 87.6 mg/dL to 89.8 mg/dL, mean levels of HDL-C decreased from 67.0 mg/dL to 48.4 mg/dL and the mean LDL-C/HDL-C ratio increased from 1.45 to 2.12. Cross-sectional associations between the serum lipoproteins and weight, triceps skinfold thickness, and ponderosity (wt/ht3) were stronger in year 6 than in year 1. A persistence of ranks was observed between year 1 and year 6 for LDL-C (r = 0.61), HDL-C (r = 0.51), and LDL-C/HDL-C (r = 0.50). Multiple linear regression indicated that year 6 LDL-C levels were positively related to year 1 LDL-C, year 1 Tanner stage (an indication of sexual maturation), and the change in skinfold thickness during follow-up. Follow-up LDL-C/HDL-C was related both to change in height (negatively) and to change in weight (positively), after controlling for year 1 LDL-C/HDL-C. These longitudinal findings were similar to those obtained from earlier cross-sectional analyses and were further verified on an independent cohort of white boys also followed for five years (1976-1977 through 1981-1982).(ABSTRACT TRUNCATED AT 250 WORDS)

Tracking of serum lipids and lipoproteins in children over an 8-year period: the Bogalusa Heart Study

Although children initially identified as having elevated levels of coronary heart disease risk factors tend to have elevated follow-up levels (track), a substantial proportion show regression to the mean. Relationships of both genetic and environmental factors to tracking of serum lipids and lipoproteins over an 8-year period were examined in children from a biracial community. Associations between initial and follow-up levels were similar at 3, 5, and 8 years of follow-up; however, differences between the race-sex groups were observed. Two initial measurements reduced the number of nontrackers (children with high initial and decreased follow-up levels). Fathers of children showing persistently elevated levels of either serum total cholesterol or triglycerides were more likely to have diabetes mellitus or to have had heart attacks than were fathers of nontrackers. Children tracking for elevated low-density lipoprotein cholesterol levels had larger increases in triceps skinfold thickness than did the nontrackers. Children consuming alcohol tended to have elevated levels of high-density and decreased levels of low-density lipoprotein cholesterol at follow-up. These observations indicate that the use of repeated serum lipid and lipoprotein determinations, along with measurements of obesity and information concerning family history of heart attack and diabetes mellitus, can aid in the prediction of future elevated serum lipid and lipoprotein levels.

Type 2 (non-insulin-dependent) diabetes mellitus and coronary heart disease-chicken, egg or neither?

review of the literature yields much evidence against a correlation between duration of non-insulin-dependent diabetes mellitus (Type 2 diabetes) and the degree of coronary atherosclerosis or the risk of clinically evident coronary heart disease (CHD). Furthermore, an increased risk of CHD, similar to that in previously diagnosed diabetic subjects, has been demonstrated in persons with impaired glucose tolerance. These observations suggest that an increased risk of CHD is not a consequence of the development of diabetes (i.e. persistent hyperglycaemia). It is more likely that diabetes develops in individuals who already possess characteristics which increase the risk of CHD in addition to the risk of developing diabetes.