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Children initially aged 21/2 to 14 years living in Bogalusa, Louisiana (n = 2530) were examined twice, 3 years apart, for fasting serum pre-beta- and beta-lipoprotein cholesterol (beta-LPC) levels. Based on averages of these levels, the children were ranked for pre-beta- and beta-LPC in combinations of extreme quintiles (low-low, high-high) or quartiles (low-high, high-low), n = 388, and were reexamined for serum lipids, lipoprotein cholesterol, glucose tolerance, and anthropometry. Skinfolds were thicker in whites than in blacks except for subscapular skinfold. Children in the high-high stratum were heavier and more obese. The postglucose insulin level was positively correlated with fasting serum triglycerides and pre-beta-LPC. Compared with other strata, high-high strata showed more clustering among half-hour and 1-hour plasma insulin, serum triglycerides and pre-beta-LPC, and trunk skinfolds. We conclude that racial differences in lipid and carbohydrate metabolism occur in all four strata, and that a strong clustering occurs more in the high-high stratum, which may, in part, explain the coincidence of several high cardiovascular risk factor levels observed in the same children. These observations document in free-living children changes of obesity, plasma glucose, and insulin metabolism related to serum lipoproteins that are involved in the early natural history of atherosclerosis.

A special in-depth substudy was conducted on 388 children from a total biracial (black-white) population, who were stratified on levels of serum beta- and pre-beta-lipoprotein cholesterol to explore factors associated with lipoprotein levels in childhood. Biochemical parameters on venous blood samples were obtained both on fasting subjects and after an abbreviated glucose tolerance test, along with selected anthropometric measures like height, weight, and skinfolds. Biochemical and anthropometric relationships were minimal for children with elevated beta-lipoprotein cholesterol and low pre-beta-lipoprotein cholesterol. On the other hand, children with higher levels of pre-beta-lipoprotein cholesterol, with or without elevated beta-lipoprotein cholesterol, showed associations with fatness and slightly higher levels of glucose and insulin, with other biochemical parameters considered within normal levels. These differences noted among free-living children with different levels of serum lipoproteins provide clues to mechanisms involved in the early natural history of coronary artery disease.