SERUM APOLIPOPROTEIN-A-I AND APOLIPOPROTEIN-B AS MARKERS OF CORONARY-ARTERY-DISEASE RISK IN EARLY-LIFE - THE BOGALUSA HEART-STUDY

The functional properties of the apolipoproteins (apoB and apoA-l) gov erning lipoprotein metabolism make these variables conceptually import ant as markers for coronary artery disease risk. This aspect was exami ned in a biracial (black-white) population of children as part of the Bogalusa Heart Study. White children, especially boys, showed lower co ncentrations of apoA-l and ratios of cholesterol to apoB within low-de nsity lipoprotein (LDL) than did black children. Persistence of apoB c oncentrations over time, coupled with its strong linkage with apoB gen e locus, underscores the value of detecting apoB excess early in life. Further, the impact of apoE genotypes on apoB and apoA-l levels is al ready evident in childhood. We found that, as a screening test for det ecting increased LDL cholesterol, apoB is superior to total cholestero l. Low values for apoA-l concentration, the apoA-l to apoB ratio, and LDL cholesterol to apoB ratio in children are strongly related to pare ntal incidence of myocardial infarction; no such relationship is seen with respect to lipoprotein cholesterols. Thus, expanding screening st rategies might be useful for identifying individuals with adverse apol ipoprotein profiles early in life.