Non-high-density lipoprotein cholesterol: distribution and prevalence of high serum levels in children and adolescents: United States National Health and Nutrition Examination Surveys, 2005-2010

Abstract

Objectives: To estimate age-related changes for serum concentration of non-high-density lipoprotein cholesterol (HDL-C), describe non-HDL-C distribution, and examine the prevalence of high non-HDL-C levels in children and adolescents by demographic characteristics and weight status.

Study design: Data from 7058 participants ages 6-19 years in the 2005-2010 National Health and Nutrition Examination Surveys were analyzed. A high level of non-HDL-C was defined as a non-HDL-C value ≥ 145 mg/dL.

Results: Locally weighted scatterplot smoothing-smoothed curves showed that non-HDL-C levels increased from 101 mg/dL at age 6 to 111 mg/dL at age 10, decreased to 101 mg/dL at age 14, and then increased to 122 mg/dL at age 19 in non-Hispanic white males. Non-HDL-C levels generally were greater in female than male subjects, lower in non-Hispanic black subjects, and similar in male and slightly lower in female Mexican American subjects, compared with non-Hispanic white subjects. The overall mean was 108 (SE 0.5), and the percentiles were 67 (5th), 74 (10th), 87 (25th), 104 (50th), 123 (75th), 145 (90th), and 158 (95th) mg/dL. Mean and percentiles were greater among age groups 9-11 and 17-19 years than others and greater among non-Hispanic white than non-Hispanic black subjects. The prevalence of high non-HDL-C was 11.8% (95% CI 9.9%-14.0%) and 15.0% (95% CI 12.9%-17.3%) for the age groups 9-11 and 17-19, respectively. It varied significantly by race/ethnicity and overweight/obesity status.

Conclusion: Non-HDL-C levels vary by age, sex, race/ethnicity, and weight classification status. Evaluation of non-HDL-C in youth should account for its normal physiologic patterns and variations in demographic characteristics and weight classification.

Keywords: BMI; Body mass index; CDC; Centers for Disease Control and Prevention; HDL-C; High-density lipoprotein cholesterol; LDL-C; Locally weighted scatterplot smoothing; Low-density lipoprotein cholesterol; Lowess; NHANES; National Health and Nutrition Examination Survey; TC; Total cholesterol.