Cholesterol and arterial distensibility in the first decade of life - A population-based study

Background-Blood cholesterol levels are a key determinant of coronary heart disease risk in adults, but the importance of lipid levels in the general population during childhood is less clear. We related arterial distensibili ty, a marker of vascular function known to be altered early in atherosclero sis, to the lipid profile of a population-based sample of children aged 9 t o 11 years. Methods and Results-A noninvasive ultrasound technique was used to measure arterial distension during the cardiac cycle in the brachial arteries of 36 1 children from 4 towns in the United Kingdom. This measure was related to their pulse pressure to assess arterial distensibility. All the children ha d previously had a comprehensive assessment of cardiovascular risk includin g a full lipid profile, cotinine-assessed smoke exposure, serum glucose, an d questionnaire data on socioeconomic and dietary factors. Mean total chole sterol in the population was 4.72 [SD 0.75] mmol/L. There was a significant , inverse relation between cholesterol and distension of the artery across this range (linear regression coefficient -11.8 mu m . mmol(-1) . L-1, P=0. 003). Similar relationships were demonstrated with LDL and apolipoprotein B (-12.9 mu m . mmol(-1) . L-1, P=0.005 and -36.9 mu m/mmol/L, P=0.01). HDL and triglyceride levels showed no consistent association with distensibilit y. Conclusions-LDL cholesterol levels had an impact on arterial distensibility in the first decade of life. Furthermore, the functional differences in th e arterial wall were demonstrated within the lipid range found in normal ch ildren, a finding that raises the possibility that cholesterol levels in th e general population during childhood may already be relevant to the develo pment of vascular disease.