239 - Utility of Lipid Panel and Atherogenic Index of Plasma in Children and Adolescents in an Urban Multiethnic Community Hospital

Publication Number: 239.7047

Aya Majzoub, Flushing Hospital Medical Center, Queens, NY, United States; Luke Keating, MediSys Health Network, Forest Hills, NY, United States; Lily Q. Lew, Flushing Hospital Medical Center, Flushing, NY, United States; Yasser Elhashash, Flushing Hospital Medical Center, Brooklyn, NY, United States; Luane Bloomfield, flushing hospital, Queens, NY, United States

Background: The AAP recommends lipid screening for all children aged 9-11 and 17-21 yrs. Dyslipidemia and higher body mass index (BMI) are known risk factors for cardiovascular diseases (CVD). Atherogenic index of plasma (AIP) or log of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio is a predictor of atherosclerosis and CVD in adults. Data on AIP in pediatrics are limited.

Objective: To evaluate utility of AIP in predicting CVD risk compared to lipid screening.

Design/Methods: A retrospective chart review of patients aged ≤19 yrs with lipid screening between Jan 1, 2021 and Dec 31, 2023. Demographics (age, gender, ethnicity), BMI, blood pressure (BP) and family history (FH) were extracted from EHR. Normal total cholesterol (TC) < 170 mg/dL, TG < 90 mg/dL, low-density lipoprotein cholesterol (LDL-C) < 110 mg/dL, HDL-C>45 mg/dL; normal BMI 5- < 85%ile, overweight 85- < 95%ile, obese >95%ile for age and gender; normal BP < 120/75 for 12-18 yrs; normal glucose < 100 mg/dL. AIP was calculated for each case and categorized as low ( < 0.11), moderate (0.11-0.21), or high (>0.21) risk. Agreement rates between TC, LDL-C, and AIP risk classifications were assessed overall with components of lipid screening test and compared with BMI, BP and glucose. A p< 0.05 was considered significant.

Results: Of 1089 patients having first lipid screen, half were female (51%) having mean age of 13.9±2.4 yrs. The majority of reported ethnicity was Hispanic (89%) followed by Asian (7%) and African American (3%). Overweight BMI was in a quarter (24%) and obese BMI in 14%. Having low HDL-C (37%) and high TC (36%) was about equal and almost twice as common as having high LDL-C (19%). FH was not included in analysis due to missing data. Chance-adjusted agreement of high-risk AIP (65%) with high TC and high LDL-C was significant, p< 0.001. Levels of agreement were poor with TC (κ=0.06) and LDL-C (κ=0.20) with absolute rates of agreement of 41% and 55%, respectively. LDL-C was associated with higher diastolic BP (DBP) (β=0.07, SE=0.41, p=0.02), but not with systolic BP (SBP) (p=0.32) or glucose (p=0.75). TC was associated with higher SBP (β=0.09, SE=0.83, p=0.02) and glucose (β=0.07, SE=0.86, p=0.01), but not with DBP (p=0.17). Only AIP was associated with all three clinical markers of CVD risk (SBP: β=0.09, SE=0.49, p< 0.001; DBP: β=0.07, SE=0.35, p=0.01; glucose: β=0.06, SE=0.86, p=0.02).

Conclusion(s): In our small sample, AIP was a sensitive indicator of CVD risk compared to high LDL-C and TC levels and suggested its potential utility in pediatric lipid screening programs.