Low-Density Lipoprotein Cholesterol versus Particle Number in Middle School Children - 23/07/13

Doi : 10.1016/j.jpeds.2013.01.012

Michele Mietus-Snyder, MD ¹, Kimberly L. Drews, PhD ^2,^⁎ , James D. Otvos, PhD ³, Steven M. Willi, MD ⁴, Gary D. Foster, PhD ⁵, Russell Jago, PhD ⁶, John B. Buse, MD, PhD ⁷
HEALTHY Study Group^{^∗}
A list of members of the HEALTHY Study Group is available at www.jpeds.com (Appendix).
¹ George Washington University School of Medicine & Health Sciences, Children's National Medical Center, Washington, DC
² The George Washington University Biostatistics Center, Rockville, MD
³ LipoScience, Inc, Raleigh, NC
⁴ Children's Hospital of Philadelphia, Philadelphia, PA
⁵ Center for Obesity Research and Education, Temple University, Philadelphia, PA
⁶ Center for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
⁷ University of North Carolina School of Medicine, Chapel Hill, NC

^∗Reprint requests: Kimberly L. Drews, PhD, The George Washington University Biostatistics Center, 6110 Executive Blvd, Suite 750, Rockville, MD 20882.

Abstract

Objectives

To characterize lipids and lipoproteins in a diverse school-based cohort and identify features associated with discordance between low-density lipoprotein cholesterol (LDL-C) and LDL particle (LDL-P).

Study design

Sixth-grade children enrolled in the HEALTHY trial (n = 2384; mean age 11.3 ± 0.6 years; 54.2% female) were evaluated for standard lipids, lipoprotein particles measured by nuclear magnetic resonance, and homeostatic model of insulin resistance. Characteristics of subgroups with values of LDL-C and LDL-P discordant by >20 percentile units, an amount reasoned to be clinically significant, were compared.

Results

Four-hundred twenty-eight (18%) of children were in the LDL-P < LDL-C subgroup and 375 (16%) in the LDL-P > LDL-C subgroup. Those with LDL-P > LDL-C had significantly greater body mass index, waist circumference, homeostatic model of insulin resistance, triglycerides, systolic and diastolic blood pressure, and reflected a greater Hispanic ethnic composition but fewer of black race than both the concordant (LDL-P ≅ LDL-C) and opposite discordant (LDL-P < LDL-C) subgroups.

Conclusions

There is as much lipoprotein cholesterol compositional heterogeneity in sixth graders as has been described in adults and a discordant atherogenic phenotype of LDL-P > LDL-C, common in obesity, is often missed when only LDL-C is considered. Conversely, many children with moderate-risk cholesterol measures (75th to 99th percentile) have a lower LDL-P burden.

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Keyword : apoB, BMI, CVD, HDL-C, HDL-P, HOMA-IR, LDL, LDL-C, LDL-P, NMR, TC, TG, VLDL, VLDL-P

Plan

	Funded by the National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of Health (U01-DK61230, U01-DK61249, U01-DK61231, and U01-DK61223) and the American Diabetes Association. The authors declare no conflicts of interest.
	Registered with clinicaltrials.gov: NCT00458029.

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Vol 163 - N° 2

P. 355 - août 2013 Retour au numéro

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Low-Density Lipoprotein Cholesterol versus Particle Number in Middle School Children - 23/07/13

Abstract

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