Optimal high-density lipoprotein cholesterol cutoff for predicting cardiovascular disease: Comparison of the Korean and US National Health and Nutrition Examination Surveys

J Clin Lipidol. 2015 May-Jun;9(3):334-42. doi: 10.1016/j.jacl.2015.01.009. Epub 2015 Feb 2.

Abstract

Background: Serum high-density lipoprotein cholesterol (HDL-C) has been reported to be lower in Asians than in Caucasians.

Objective: We compared HDL-C levels between the Korean and US populations using stratified analysis according to age and sex and estimated the optimal cutoff value for HDL-C that best predicts the risk of cerebrovascular accidents (CVAs) and ischemic heart disease (IHD) in Koreans.

Methods: The Korean National Health and Nutrition Examination Survey (KNHANES) 2010-2012 and the National Health and Nutrition Examination Survey (NHANES) 2011-2012 were used for the Korean and US populations, respectively. HDL-C levels were compared using general linear models. To estimate the optimal HDL-C cutoff value that predicts CVAs and IHD, sensitivity and specificity of different HDL-C levels were calculated.

Results: The mean HDL-C level was significantly lower in KNHANES in both sexes (46.1 [standard error, 0.2] mg/dL in KNHANES and 47.7 [0.5] mg/dL in NHANES, P = .003 in men, and 51.2 [0.2] mg/dL in KNHANES and 58.3 [0.8] mg/dL in NHANES, P < .001 in women). The optimal HDL-C cutoff to predict CVA-IHD was 43 mg/dL and 48 mg/dL for Korean men and women, respectively, and 41 mg/dL and 56 mg/dL for US men and women, respectively.

Conclusion: HDL-C levels are significantly lower in both sexes in the Korean population than the US population. The optimal cutoff HDL-C value to predict the risk of CVA-IHD was 43 mg/dL for men and 48 mg/dL for women in the Korean population.

Keywords: Cerebrovascular accidents; HDL cholesterol; Ischemic heart disease; Korean; National Health and Nutrition Examination Survey.

Publication types

  • Comparative Study

MeSH terms

  • Cholesterol, HDL / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / blood*
  • Myocardial Ischemia / diagnosis*
  • Myocardial Ischemia / epidemiology
  • Republic of Korea / epidemiology
  • Risk Factors
  • Sex Factors
  • United States / epidemiology

Substances

  • Cholesterol, HDL