Adult dyslipidemia prediction is improved by repeated measurements in childhood and young adulthood : the Cardiovascular Risk in Young Finns Study

Background: Prediction of adult dyslipidemia has been suggested to improve with multiple measurements in childhood or young adulthood, but there is paucity of specific data from longitudinal studies. Methods and results: The sample comprised 1912 subjects (54% women) from the Cardiovascular Risk in Young Finns Study who had fasting lipid and lipoprotein measurements collected at three time-points in childhood/young adulthood and had at least one follow-up in later adulthood. Childhood/young adult dyslipidemia was defined as total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) or triglycerides (TG) in the highest quintile, or high-density lipoprotein cholesterol (HDL-C) in the lowest quintile. Adult dyslipidemia was defined according to European cut-points (TC>5.0mmol/L, LDL-C >3mmol/L, Non-HDL-C >3.8mmol/L, HDL-C <1.0mmol/L (in men)/<1.2mmol/L (in women) and TG>1.7mmol/L). With the exception of triglycerides, Pearson correlation coefficients for predicting adult levels significantly improved when two lipid or lipoprotein measurements in childhood/young adulthood were compared with one measurement (all P<0.01). For triglycerides, there was significant improvement only when three measurements were considered (P=0.004). Two measurements significantly improved prediction of dyslipidemia levels in adulthood for non-HDL-C, LDL-C, HDL-C and TG compared with one measurement (P<0.05 for improved area-under the receiver-operating characteristic curve). Risk of dyslipidemia in adulthood grew according to the number of times a person had been at risk in childhood. Conclusions: Based on these results, it seems that compared to a single measurement two lipid measures in childhood/early adulthood significantly improve prediction of adult dyslipidemia. A lack of dyslipidemia in childhood does not strongly exclude later development of dyslipidemia. Multiple measurements increase the prediction accuracy, but the incremental prognostic/diagnostic accuracy of especially third measurement is modest.