ApoB48-remnant lipoproteins are associated with increased cardiometabolic risk in adolescents

• Published in: Atherosclerosis 2020-06, Vol.302, p.20-26
• Main Authors: Krysa, Jacqueline A., Vine, Donna F., Beilin, Lawrence J., Burrows, Sally, Huang, Rae-Chi, Mori, Trevor A., Proctor, Spencer D.
• Format: Article
• Language: English
• Subjects: Adiposity; Adolescence; Chylomicron metabolism; Lipoproteins; Metabolic syndrome
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2020.04.021

Cardiovascular disease (CVD) begins in youth, and is exacerbated by obesity and metabolic syndrome. Apolipoprotein (Apo)B-remnant cholesterol is considered a primary contributor to CVD risk. Fasting plasma apoB48 can be used as a biomarker of intestinal remnant cholesterol as well as postprandial dyslipidemia. In adults, elevated fasting plasma apoB48 strongly associates with cardiometabolic risk factors and obesity, whereas in adolescents there is limited data. The aim of this study was to measure fasting plasma apoB48 and determine the relationship with cardiometabolic risk factors in adolescents. This is a cross-sectional study of fasting plasma apoB48 from the Western Australian Pregnancy Cohort (Raine) Study. Subjects were adolescent males and females aged 17 years with complete fasting plasma apoB48, biochemical, and anthropometry data (n = 1045). The relationship between fasting plasma apoB48 and other cardiometabolic risk factors was determined. The high-risk metabolic cluster variable was defined using elevated BMI, HOMA-IR, fasting plasma triglycerides, and systolic blood pressure. Fasting plasma apoB48 was significantly higher in male (15.28 ± 2.95 μg/mL) compared to female (12.45 ± 2.43 μg/mL) adolescents (p = 0.0003), and was increased by 21% (3.60 μg/mL; p = 0.0000) in the high-risk metabolic cluster group and more pronounced in males (31%, 6.15 μg/mL; p = 0.0000). Fasting plasma apoB48 was positively associated with fasting plasma triglycerides, total-cholesterol (but not LDL-C), insulin, leptin, HOMA-IR, and the anthropometric parameters, waist-circumference and skinfold-thickness. Fasting plasma apoB48 was inversely associated with fasting plasma HDL-C, and adiponectin. Plasma apoB48 remnant lipoproteins associate with cardiometabolic risk factors in adolescents and provide support for the screening of remnant cholesterol in youth. [Display omitted] •Classic fasting lipid markers of CVD risk are often unreliable in youth and adolescents due to the impact of puberty.•Remnant lipoproteins and their metabolism have emerged as clinically significant independent markers of CVD.•Fasting apoB48 (marker of intestinal remnants) was positively associated with cardiometabolic risk (but not LDL-C).•Findings suggest that remnant lipoprotein metabolism maybe useful to assess cardiometabolic risk in adolescents and youth.