Lipoprotein heterogeneity at birth: Influence of gestational age and race on lipoprotein subclasses and LP (A) lipoprotein

Objective: To determine the influence of gestational age, gender, and race, on lipoprotein heterogeneity at birth. Design: Prospective study of representative sample of infants. Setting: The Johns Hopkins Hospital. Participants: 163 infants (70 White and 93 Black) >28 weeks gestational age. Intervention: None. Main Outcome Measures: Lipids, lipoprotein subclasses, apolipoproteins, Lp (a) lipoprotein. Results: The number of low-density lipoprotein (LDL) particles, large LDL subclass, and LDL cholesterol level, were all significantly higher in the younger infants. The large high-density lipoprotein (HDL) subclass was significantly higher, while the small HDL subclass was significantly lower in the younger infants. Female infants had a greater HDL size than did males (P=.03). There were no differences between the age groups for HDL cholesterol, very low-density lipoprotein subclasses, or levels of triglycerides, or apolipoproteins B and A-I. White infants had a notably higher mean (SD) level (nmol/L) of total LDL particles (476 [251]), compared to the Black infants (372 [177]) (P=.009). The Black infants had a significantly (P=.02) higher mean (SD) Lp (a) lipoprotein level (mg/dL), compared to the White infants, 2.8 (3.2) vs 1.7 (2.4). Black small-for-gestational age infants had significantly higher levels of very low and intermediate density lipoproteins and apolipoprotein B, compared to appropriate-for-gestational age infants. Conclusions: Gestational age has a significant effect on both LDL and HDL subclasses. Differences in LDL particle number and Lp (a) between White and Black infants mirror those seen later in life.