Simulated intervention and optimal timing for attenuating dyslipidaemia-related atherosclerotic progression in the young: a temporal inverse allocation analysis of the ALSPAC cohort

Abstract Background Carotid intima-media thickness (cIMT) progression strongly predicts cardiovascular events among adults. We recently reported that cumulative dyslipidaemia was longitudinally associated with cIMT adolescents and young It is of clinical public health significance to identify the most sensitive or crucial timing for preventing diseases before mid-adulthood. One method addressing these issues perform a temporal inverse allocation simulate effects treatment at specific life stages, in order inform effective treatment. The similar principle isotemporal substitution, however, rather than eliminating variables interest, participants' categories are reversed, i.e participants time point assigned normal lipid levels vice versa, while other points unchanged. Purpose To intervention on longitudinal associations total cholesterol (TC), non–high-density lipoprotein (non–HDL-C), high-density (HDL-C), triglyceride, low-density (LDL-C) progression. Methods studied 1779 British 15-year-olds (50% females) followed up 9 years. TC, HDL-C were measured line standard protocols ages 15, 17, 24 years, respectively. non-HDL-C LDL-C estimated. Lipid phenotypes categorized based 2011 National Heart, Lung, Blood Institute classification into (reference) elevated/dyslipidaemia. right left common carotid arteries 17 years ultrasound. conducted linear mixed-effect model analyses adjusted age, sex, cardiometabolic, lifestyle factors. Results Normalized age elevated 15 did not alter elevated/dyslipidaemia TC: effect estimate 0.028 mm [95% CI 0.007 0.049; p=0.010], non–HDL-C: 0.027 [0.006 p=0.013], low HDL-C: −0.030 [−0.048 −0.013; p=0.001] from through 7-year However, normalized level significantly attenuated 0.005 [−0.015 0.025; p=0.627], 0.013 [−0.008 0.034; p=0.235], −0.016 [−0.031 −0.0001; p=0.049] Triglyceride Conclusion This simulated suggests lowering lipids during late adolescence may be reversing progression, marker preclinical atherosclerosis, young. Funding Acknowledgement Type funding sources: Private grant(s) and/or Sponsorship. Main source(s): Finnish Cultural Foundation