Prevention & lipidsCohort study
Childhood Non-HDL Cholesterol and LDL Cholesterol and Adult Atherosclerotic Cardiovascular Events
- Prospective cohort study
- multicohort consortium (i3C)
Authors' conclusion
Childhood non-HDL-C and LDL-C levels are associated with ASCVD events in midlife. Non-HDL-C is better than LDL-C in predicting adult ASCVD events, particularly among individuals who had normal LDL-C but elevated non-HDL-C.
Study context
- Population
- Children followed into adulthood in the i3C Consortium (mean age at childhood visits 11.9 years)fatal/nonfatal subset n = 11,296
- Participants
- 21,126 children
- Exposure
- Childhood non-HDL-C vs low-density lipoprotein cholesterol (LDL-C) levels
- Outcome
- Incident fatal and fatal/nonfatal ASCVD events
- Follow-up
- Average 35 years
Main finding
As reported in the abstract
Fatal and fatal/nonfatal ASCVD events per unit increase in childhood non-HDL-C or LDL-C z score
Childhood non-HDL-C or LDL-C z score (per unit)Hazard ratio (95% CI)
lower bound of HR range
1.27(1.14–1.41)
upper bound of HR range
1.35(1.13–1.60)
Per unit, as printed
- Fatal atherosclerotic cardiovascular disease (ASCVD) events in 21 126 participants
- 153
- Fatal/nonfatal ASCVD events in subset of 11 296
- 352
Observational data: associations, not effects.
Further findings
| Outcome | difference in C index (95% CI) | |
|---|---|---|
| Discrimination (C index), non-HDL-C vs LDL-C — non-HDL-C vs LDL-C · fatal events | 0.0054 (0.0006–0.0102) | |
| Discrimination (C index), non-HDL-C vs LDL-C — non-HDL-C vs LDL-C · fatal/nonfatal events | 0.0038 (0.0008–0.0068) | |
| −0.00500.0050.010.015Difference (linear scale) |
| Outcome | HR (95% CI) | |
|---|---|---|
| ASCVD events by concordant/discordant non-HDL-C and LDL-C categories — Elevated non-HDL-C and normal LDL-C vs Normal non-HDL-C and LDL-C · fatal events | 1.90 (0.98–3.70) | |
| ASCVD events by concordant/discordant non-HDL-C and LDL-C categories — Elevated non-HDL-C and normal LDL-C vs Normal non-HDL-C and LDL-C · fatal/nonfatal events | 1.94 (1.23–3.06) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Childhood Non-HDL Cholesterol and LDL Cholesterol and Adult Atherosclerotic Cardiovascular Events. Circulation. Published 28 November 2023. doi:10.1161/circulationaha.123.064296
Summarised from the published abstract; every number is checked against it