Abstract
Dyslipidaemia in adolescence tracks into adulthood and is an important risk factor for cardiovascular disease. Little is known about the effects of environmental exposures and early-life exposure to infectious diseases common to tropical regions on lipids. In 1119 early adolescent participants in the Entebbe Mother and Baby Study, we used linear regression to examine whether prenatal, childhood or adolescent factors are associated with lipid levels. Reduced high-density lipoprotein (HDL) and elevated triglyceride levels were common (prevalence 31% and 14%, respectively), but elevated low-density lipoprotein (LDL) or total cholesterol (TC) were rare. Current malaria infection was associated with lower mean LDL (adjusted ß − 0.51; 95% CI − 0.81, − 0.21), HDL (adjusted ß − 0.40; 95% CI − 0.56, − 0.23), and TC levels (adjusted ß − 0.62; 95% CI − 0.97, − 0.27), but higher mean triglyceride levels (geometric mean ratio (GMR) 1.47; 95% CI 1.18–1.84). Early-life asymptomatic malaria was associated with modest reductions in HDL and TC. Body mass index (BMI) was positively associated with LDL, TC, and triglycerides. No associations with helminth infection were found. Our findings suggest that early-life factors have only marginal effects on the lipid profile. Current malaria infection and BMI are strongly associated with lipids and important to consider when trying to improve the lipid profile.
Highlights
Dyslipidaemia in adolescence tracks into adulthood and is an important risk factor for cardiovascular disease
The pathophysiology leading to the end stages of Cardiovascular diseases (CVDs) is complex and many risk factors have been identified, with smoking, obesity, diabetes, hypertension and abnormal cholesterol levels implicated to be of particular importance[3,4,5]
In Africa, dyslipidaemia is common in adults: a recent systematic review and meta-analysis reported a prevalence of 29% for elevated low-density lipoprotein (LDL) and 37% for reduced high-density lipoprotein (HDL)[8]
Summary
Dyslipidaemia in adolescence tracks into adulthood and is an important risk factor for cardiovascular disease. Reduced high-density lipoprotein (HDL) and elevated triglyceride levels were common (prevalence 31% and 14%, respectively), but elevated lowdensity lipoprotein (LDL) or total cholesterol (TC) were rare. In Africa, dyslipidaemia is common in adults: a recent systematic review and meta-analysis reported a prevalence of 29% for elevated low-density lipoprotein (LDL) and 37% for reduced high-density lipoprotein (HDL)[8]. Dyslipidaemia is less common in adolescents, yet, if present, is likely to increase the risk of CVD events later in life and may lead to early death, because lipid levels in adolescence are strongly correlated with lipid levels in later life[12,13]. Understanding which factors influence lipid levels, LDL and HDL, in adolescents may inform intervention strategies to reduce CVD risk. With regard to lifestyle factors, many studies have explored the effect of nutritional
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