Coexistence of increased levels of adiposity, insulin, and blood pressure in a young adult cohort with elevated very-low-density lipoprotein cholesterol: The Bogalusa Heart Study

Abstract

Clustering and interrelationships of elevated levels (>75th percentile) of adiposity, insulin, blood pressure, and very-low-density lipoprotein cholesterol (VLDL-C) were examined in a selected subset (n = 89) of a young adult cohort aged 18 to 26 years, whose childhood (ages 10 to 18 years) VLDL-C and/or low-density lipoprotein cholesterol (LDL-C) levels were in the upper or lower percentiles of the distribution. Among the young adults with elevated VLDL-C and LDL-C levels, 23% had increased adiposity and systolic blood pressure, 17% had increased insulin levels and systolic blood pressure, 17% had increased insulin levels and adiposity, and 13% had increased insulin levels, adiposity, and systolic blood pressure; corresponding values among those with elevated VLDL-C and normal (<75th percentile) LDL-C levels were 29%, 18%, 24%, and 18%. As adults, the group with elevated VLDL-C and LDL-C levels had increased adiposity ( P = .02) and systolic blood pressure ( P = .002) in comparison to those with normal VLDL-C and LDL-C levels, whereas the group with elevated VLDL-C and normal LDL-C levels had increased fasting plasma insulin levels ( P = .05) and systolic blood pressure ( P = .007). These 89 individuals had undergone a glucose tolerance test during childhood. As children, the group with elevated VLDL-C and LDL-C levels displayed increased adiposity ( P = .001), post-glucose plasma insulin response ( P = .02), and fasting plasma free fatty acid levels ([FFA] P = .05) in comparison to those with normal VLDL-C and LDL-C levels; on the other hand, the group with elevated VLDL-C and normal LDL-C levels had increased fasting plasma FFA levels ( P = .05) and post-glucose plasma FFA response ( P = .04). Thus, conditions of elevated adiposity, insulin level, and blood pressure strongly coexist in “healthy” young adults with elevated VLDL-C levels, and subtle abnormalities in measures of carbohydrate and lipid metabolism are already apparent in their childhood.