Significance of lipids, lipoproteins, and apolipoproteins during the first 14-16 months of life

Abstract

Background and aims: The aims of this study were to investigate lipid parameters during the first 14-16 months of life, to identify influential factors, and to test whether high concentrations at birth predict high concentrations at 2- and 14-16 months.

Methods: The Copenhagen Baby Heart Study, including 13,354 umbilical cord blood samples and parallel venous blood samples from children and parents at birth (n = 444), 2 months (n = 364), and 14-16 months (n = 168), was used.

Results: Concentrations of lipids, lipoproteins, and apolipoproteins in umbilical cord blood samples correlated highly with venous blood samples from newborns. Concentrations of low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein (HDL) cholesterol, apolipoprotein B, and lipoprotein(a) increased stepwise from birth to 2 months to 14-16 months. Linear mixed models showed that concentrations of LDL cholesterol, non-HDL cholesterol, and lipoprotein(a) above the 80th percentile at birth were associated with significantly higher concentrations at 2 and 14-16 months. Finally, lipid concentrations differed according to sex, gestational age, birth weight, breastfeeding, and parental lipid concentrations.

Conclusions: Lipid parameters changed during the first 14-16 months of life, and sex, gestational age, birth weight, breastfeeding, and high parental concentrations influenced concentrations. Children with high concentrations of atherogenic lipid traits at birth had higher concentrations at 2 and 14-16 months. These findings increase our knowledge of how lipid traits develop over the first 14-16 months of life and may help in deciding the optimal child age for universal familial hypercholesterolaemia screening.

Keywords: Apolipoproteins; Lipids; Lipoproteins; Prevention; Umbilical cord blood.

Structured Graphical Abstract

An illustration of the aim, methods, and findings of the study. The findings are shown for LDL cholesterol as an example. LDL = low-density lipoprotein. HDL = high-density lipoprotein.

Figure 1

Newborn venous blood as a function of umbilical cord blood at birth for all lipid parameters. Scatter plots of parallel umbilical cord blood and venous blood measurements at birth with overlaying linear regression models and Spearman’s correlation coefficients. The number of individuals with results from both umbilical cord blood and venous blood at birth was 314–349. LDL = low-density lipoprotein. HDL = high-density lipoprotein.

Figure 2

Developments in lipid parameters during the first 14–16 months after birth in child venous blood. Density plots of venous blood concentrations in children at birth, 2 months, and 14–16 months with median and 25th and 75th percentiles. The number of individuals with venous blood samples ranged from 349–387 at birth, 323–334 at 2 months, and 89–168 at 14–16 months. LDL = low-density lipoprotein. HDL = high-density lipoprotein.

Figure 3

Developments in lipid parameters during the first 14–16 months after birth stratified on being above or below/equal to the 80th percentile at birth. Predicted means with 95% confidence intervals from linear mixed models for repeated measurements for lipid parameters at birth, at 2 months, and at 14–16 months. Red lines indicate children with venous blood concentrations above the 80th percentile at birth and blue lines indicate children with concentrations below/equal to the 80th percentile according to sex and gestational age. LDL = low-density lipoprotein. HDL = high-density lipoprotein.