B3815 - Cholesterol trajectories throughout childhood and associations with growth and carotid intima-media thickeness - 28/06/2021

B number: 
Principal applicant name: 
Laila J Tata | School of Medicine, University of Nottingham (United Kingdom)
Professor Nadeem Qureshi, Professor Steve Humphries
Title of project: 
Cholesterol trajectories throughout childhood and associations with growth and carotid intima-media thickeness
Proposal summary: 

Cholesterol is a type of fat that is essential for our body to work well. Among its roles, it helps the body make use of hormones and vitamins. Our bodies make cholesterol, but we also get cholesterol from food. When we eat too many foods high in fat we can start to have a build-up of cholesterol in our bodies, especially in our blood vessels. We know that having too much bad cholesterol (called Low-Density Lipoprotein or LDL-cholesterol) in our blood can result in forming a layer that sticks to the inside walls of our blood vessels, making them thinner and sometimes blocking them, which can result heart disease, such as having a heart attack.

We know what levels of LDL-cholesterol are considered too high in adults, but we know very little about what normal and high levels of LDL-cholesterol are in children. We know cholesterol is important for brain development, that cholesterol may go up and down at certain ages in children, but there are very few studies of how cholesterol changes normally throughout childhood and adolescence. We also know little about how young people’s cholesterol is related to their growth and health (for example, weight and blood pressure), or whether it is related to early signs of heart disease in early adulthood.

We will answer these questions using this cohort. The results will be important for the general population and for children who have certain conditions that require medications to lower their cholesterol in childhood.

Impact of research: 
We believe this study will provide important information in characterising cholesterol profiles in childhood and that this information will fill an important evidence gap that will be valuable for many studies of cardiovascular health not only in the UK but internationally. As described in the previous section, in addition to providing standalone valuable information for the general population of children and useful information for predicting future risk of cardiovascular health, this ALSPAC analysis will be used to provide more immediate impact for informing a study on the treatment of FH in childhood. We will assess whether cholesterol trajectories in children with untreated FH are similar to those in the general ALSPAC population, or how they differ. We will also use information from the ALSPAC study to model the risk of early evidence of atherosclerosis in children with FH because there are no available following up children with FH long enough to incorporate childhood and early adulthood. The latter will inform our economic models to estimate the benefits of starting statins at different ages in childhood. By the end of the 5-year project on FH, we aim to provide clearer evidence on what age and LDL-C level children with FH should ideally start statins, based on their clinical risk profile. The impact could be changing or strengthening current clinical guidelines in treatment of FH.
Date proposal received: 
Thursday, 17 June, 2021
Date proposal approved: 
Monday, 21 June, 2021
Epidemiology, Hypercholesterolaemia, cardiovascular disease, Statistical methods, Cardiovascular