Author + information
- Received July 24, 2015
- Revision received September 29, 2015
- Accepted October 6, 2015
- Published online January 19, 2016.
- John T. Wilkins, MD, MS∗∗ (, )
- Ron C. Li, MD∗,
- Allan Sniderman, MD†,
- Cheeling Chan, MS∗ and
- Donald M. Lloyd-Jones, MD, ScM∗
- ∗Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- †Department of Medicine (Cardiology), McGill University, Montreal, Quebec, Canada
- ↵∗Reprint requests and correspondence:
Dr. John T. Wilkins, Department of Preventive Medicine, Division of Medicine (Cardiology), Northwestern University, Feinberg School of Medicine, 680 North Lakeshore Drive, Suite 1400, Chicago, Illinois 60611.
Background High levels of apolipoprotein B (apoB) have been shown to predict atherosclerotic cardiovascular disease (CVD) in adults even in the context of low levels of low-density lipoprotein cholesterol (LDL-C) or non–high-density lipoprotein cholesterol (non–HDL-C).
Objectives This study aimed to quantify the associations between apoB and the discordance between apoB and LDL-C or non–HDL-C in young adults and measured coronary artery calcium (CAC) in midlife.
Methods Data were derived from a multicenter cohort study of young adults recruited at ages 18 to 30 years. All participants with complete baseline CVD risk factor data, including apoB and year 25 (Y25) CAC score, were entered into this study. Presence of CAC was defined as having a positive, nonzero Agatston score as determined by computed tomography. Baseline apoB values were divided into tertiles of 4 mutually exclusive concordant/discordant groups, based on median apoB and LDL-C or non–HDL-C.
Results Analysis included 2,794 participants (mean age: 25 ± 3.6 years; body mass index: 24.5 ± 5 kg/m2; and 44.4% male). Mean lipid values were as follows: total cholesterol: 177.3 ± 33.1 mg/dl; LDL-C: 109.9 ± 31.1 mg/dl; non–HDL-C: 124.0 ± 33.5 mg/dl; HDL-C: 53 ± 12.8 mg/dl; and apoB: 90.7 ± 24 mg/dl; median triglycerides were 61 mg/dl. Compared with the lowest apoB tertile, higher odds of developing Y25 CAC were seen in the middle (odds ratio [OR]: 1.53) and high (OR: 2.28) tertiles based on traditional risk factor–adjusted models. High apoB and low LDL-C or non–HDL-C discordance was also associated with Y25 CAC in adjusted models (OR: 1.55 and OR: 1.45, respectively).
Conclusions These data suggest a dose–response association between apoB in young adults and the presence of midlife CAC independent of baseline traditional CVD risk factors.
The CARDIA study is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201300025C and HHSN268201300026C), Northwestern University (HHSN268201300027C), University of Minnesota (HHSN268201300028C), Kaiser Foundation Research Institute (HHSN268201300029C), and Johns Hopkins University School of Medicine (HHSN268200900041C). The CARDIA study is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005). This paper has been reviewed by CARDIA for scientific content.
The authors report that they have no relationships relevant to the contents of this paper to disclose.
- Received July 24, 2015.
- Revision received September 29, 2015.
- Accepted October 6, 2015.
- 2016 American College of Cardiology Foundation