Background
In adults, dyslipidemia is associated with higher carotid thickness and arterial stiffness, predictors of CV events. In young subjects, lipid concentrations have not been consistently associated with vascular measures.
Objective
To compare nuclear magnetic resonance (NMR) measures of lipoprotein particle number (LDL-P, HDL-P, VLDL-P) and size (LDL-S, HDL-S, VLDL-S) to determine if they were associated with vascular measures more strongly than lipid concentrations (LDL-C, HDL-C, TG).
Methods
We evaluated 214 lean (L), 228 Obese (O) and 214 diabetic (T2DM) subjects age 10–24 years (33% male, 39% Caucasian). CV risk factors, vascular structure and arterial stiffness were measured. General linear models were constructed including demographics, risk factors and traditional or NMR lipid parameters. A composite vascular function score was developed as the outcome in receiver operator characteristic scores (ROC) for determining which lipid parameter was superior in predicting vascular damage.
Results
Risk factors worsened from L to O to T. However, LDL-C was similar in O and T while LDL-S differentiated the 3 groups (T>O>L, p≤0.0001). Models demonstrated the superiority of NMR values which entered for all but one vascular outcome and explained more of the variance than traditional lipid concentrations. ROC curves demonstrated that NMR values were superior in predicting vascular outcomes. Models stratified by race were similar but cut-points predicting vascular outcomes differed by race for TG, TG/HDL and VLDL.
Conclusion
Lipoprotein particle number and size are more strongly related to vascular structure and function than traditional lipid values. NMR lipid measures may be a better indicator of risk for target organ damage than traditional lipid measures in adolescents and young adults.