CHILDHOOD LIPOPROTEIN PROFILES AND IMPLICATIONS FOR ADULT CORONARY-ARTERY DISEASE - THE BOGALUSA HEART-STUDY

Serum lipoproteins are important risk factor variables for coronary ar tery disease (CAD). Studies of a large population of young individuals show changes in lipoproteins in childhood are race- (black-white) and sex-specific and certain changes occur during growth phases. White bo ys show adverse changes in lipoprotein levels during sexual maturation that mark them at high risk for CAD. Further, low-density lipoprotein particles are relatively apolipoprotein B enriched in white children, especially boys, a characteristic associated with low levels of high- density lipoprotein cholesterol. The impact of apolipoprotein E genoty pe on serum lipoproteins seen in adults is already apparent in childre n, which may be helpful in identifying a high-risk group. Observations of child-parent associations in terms of parental myocardial infarcti on and levels of lipoprotein variables in the offspring suggest that c hildhood profiles of lipoprotein (a), apolipoprotein A-I, and apolipop rotein B may be helpful as markers of future CAD. Clustering of increa sed levels of truncal fat, insulin, and blood pressure is often seen i n young adults with an adverse lipoprotein profile. This clustering is related to subtle abnormalities in carbohydrate and lipid metabolism and obesity in childhood. The fact that lipoprotein levels persist fro m childhood to young adulthood underscores the importance of detection and management of dyslipidemia early in life.