Significance of lipids, lipoproteins, and apolipoproteins during the first 14-16 months of life.
Level 3 - non-randomized controlled study
Prospective birth cohort study with longitudinal follow-up
PubMed 37632410 · doi:10.1093/eurheartj/ehad547
What was done
The Copenhagen Baby Heart Study evaluated lipid, lipoprotein, and apolipoprotein concentrations in 13,354 umbilical cord blood samples alongside longitudinal venous blood samples collected from newborns and their parents at birth (n = 444), at 2 months (n = 364), and at 14-16 months of age (n = 168). Investigators assessed correlation between cord and newborn venous blood, evaluated concentration trajectories over time, and used linear mixed models to determine whether lipid levels above the 80th percentile at birth predicted elevated concentrations later in infancy, while evaluating clinical and parental covariates.
What was found
Cord blood lipid and apolipoprotein concentrations correlated highly with newborn venous blood. Concentrations of low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein (HDL) cholesterol, apolipoprotein B, and lipoprotein(a) increased stepwise across the three time points (birth to 2 months to 14-16 months). Neonates with LDL cholesterol, non-HDL cholesterol, or lipoprotein(a) above the 80th percentile at birth maintained significantly higher concentrations at 2 and 14-16 months. Lipid levels varied significantly by sex, gestational age, birth weight, breastfeeding status, and parental lipid levels (exact numerical effect sizes, correlation coefficients, and p-values were not reported in the abstract).
Why it matters
Tracking atherogenic lipid profiles from birth into the second year of life clarifies developmental lipid physiology. Demonstrating that high-percentile lipid concentrations persist into infancy may help determine the optimal timing for early screening strategies, such as universal pediatric screening for familial hypercholesterolaemia.
Limits
Longitudinal venous follow-up experienced severe sample attrition, dropping from 13,354 cord blood samples to 444 newborns at birth, 364 infants at 2 months, and 168 children at 14-16 months. The abstract reports no numerical estimates, effect sizes, confidence intervals, or correlation coefficients, and long-term clinical cardiovascular outcomes beyond 16 months were not evaluated.
Cited by
- context Human infants are typically born with an LDL cholesterol or ApoB level below 20 mg/dL.