For the study, Peter O. Kwiterovich, Jr., M.D., professor of pediatrics and director of the Lipid Clinic at Johns Hopkins, and colleagues analyzed the umbilical cord blood of 163 infants born at 28 or more weeks of gestational age at Johns Hopkins Hospital between January 3 and September 27, 2000. Nineteen percent of the babies were found to have enriched levels of apolipoprotein C-1 bound up in the high density lipoproteins (HDL) circulating in their blood. These infants were born on average 1.3 pounds less and three weeks earlier than those who had normal HDL levels of the suspect particles.

Results are published in the April 20 issue of the Journal of the American Medical Association.

In adults, HDL enriched with apolipoprotein C-1 may be dysfunctional and cause the death of smooth muscle cells that normally are an important part of the protective cap on top of cholesterol plaque in the blood vessels in the heart, Kwiterovich said. If the cap is weakened, the plaque can rupture, causing a heart attack.

"Our hypothesis is that infants with elevated apo C-1 levels at birth will have higher apo C-1 levels in childhood and adulthood" Kwiterovich said. "Many people associate HDL as being the 'good' cholesterol, and indeed, higher levels of HDL in general are, in adults, good. It is the higher apo C-1 levels in these infants that we find worth watching as an early predictor of heart disease. A low-fat diet is particularly important for these children to reduce their risk of heart disease."

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Wong says that both the serum and the saliva exhibited unique genetic profiles. The risk model yielded a predictive power of 95 percent by using only the salivary transcriptome samples and 88 percent by using only serum transcriptome samples for oral squamous cell carcinomas and for oral cancer, salivary transcriptome has a slight edge of that of serum transcriptome analysis.

It is expected that future research will involve a larger sample of cancer patients to refine prediction models and will also include studies involving precancers and other difficult to detect cancers such as ovarian and pancreatic cancers. The study proves the principal but the results will need to be validated in a larger sample size in a blinded manner.

Wong feels one of the biggest hurdles stems from the fact that salivary nucleic acids or protein markers might be influenced by eating, drinking, smoking, diet or oral hygiene, and they aim to provide the optimized and standardized protocol to assure consistent results.

The studies are supported by grants from the U.S. Public Health Service (National Institute of Dental & Craniofacial Research) and the UCLA Jonsson Comprehensive Cancer Centre to David T. Wong.

Also participating in the study were Yang Li, David Elashoff, MyungShin Oh, Stephanie Tsung, and Mai N. Brooks at UCLA.

The study is published in Clinical Cancer Research and was presented at the Annual Meeting of the American Association for Cancer Research.

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