{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T13:39:59Z","timestamp":1792935599853,"version":"4.5.0"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"21","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2024,6,4]]},"abstract":"\n Importance<\/jats:title>\n Elevated non\u2013high-density lipoprotein cholesterol (non\u2013HDL-C; a recommended measure of lipid-related cardiovascular risk) is common in children and increases risk of adult cardiovascular disease (CVD). Whether resolution of elevated childhood non\u2013HDL-C levels by adulthood is associated with reduced risk of clinical CVD events is unknown.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine the associations of non\u2013HDL-C status between childhood and adulthood with incident CVD events.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Individual participant data from 6 prospective cohorts of children (mean age at baseline, 10.7 years) in the US and Finland. Recruitment took place between 1970 and 1996, with a final follow-up in 2019.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n \n Child (age 3-19 years) and adult (age 20-40 years) non\u2013HDL-C age- and sex-specific\n z<\/jats:italic>\n scores and categories according to clinical guideline\u2013recommended cutoffs for dyslipidemia.\n <\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Incident fatal and nonfatal CVD events adjudicated by medical records.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Over a mean length of follow-up of 8.9 years after age 40 years, 147 CVD events occurred among 5121 participants (60% women; 15% Black). Both childhood and adult non\u2013HDL-C levels were associated with increased risk of CVD events (hazard ratio [HR], 1.42 [95% CI, 1.18-1.70] and HR, 1.50 [95% CI, 1.26-1.78] for a 1-unit increase in\n z<\/jats:italic>\n score, respectively), but the association for childhood non\u2013HDL-C was reduced when adjusted for adult levels (HR, 1.12 [95% CI, 0.89-1.41]). A complementary analysis showed that both childhood non\u2013HDL-C levels and the change between childhood and adulthood were independently associated with the outcome, suggesting that from a preventive perspective, both childhood non\u2013HDL-C levels and the change into adulthood are informative. Compared with those whose non-HDL-C levels remained within the guideline-recommended range in childhood and adulthood, participants who had incident non\u2013HDL-C dyslipidemia from childhood to adulthood and those with persistent dyslipidemia had increased risks of CVD events (HR, 2.17 [95% CI, 1.00-4.69] and HR, 5.17 [95% CI, 2.80-9.56], respectively). Individuals who had dyslipidemic non\u2013HDL-C in childhood but whose non-HDL-C levels were within the guideline-recommended range in adulthood did not have a significantly increased risk (HR, 1.13 [95% CI, 0.50-2.56]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Individuals with persistent non\u2013HDL-C dyslipidemia from childhood to adulthood had an increased risk of CVD events, but those in whom dyslipidemic non\u2013HDL-C levels resolve by adulthood have similar risk to individuals who were never dyslipidemic. These findings suggest that interventions to prevent and reduce elevated childhood non\u2013HDL-C levels may help prevent premature CVD.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2024.4819","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T10:30:32Z","timestamp":1712917832000},"page":"1834","source":"Crossref","is-referenced-by-count":47,"title":["Non\u2013High-Density Lipoprotein Cholesterol Levels From Childhood to Adulthood and Cardiovascular Disease Events"],"prefix":"10.1001","volume":"331","author":[{"given":"Feitong","family":"Wu","sequence":"first","affiliation":[{"name":"Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia"},{"name":"Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"David R.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen R.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Colorado School of Medicine, Children\u2019s Hospital Colorado, Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"K\u00e4h\u00f6nen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland"},{"name":"Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica G.","family":"Woo","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children\u2019s Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan R.","family":"Sinaiko","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School, Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorma S. 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