Objective
To test the hypothesis that the concentration of non–high-density lipoprotein cholesterol (non–HDL-C) is associated with the metabolic syndrome (MetS) in youth.
Study design
Data on children and adolescents aged 12-19 years (n = 2734) from the cross-sectional National Health and Nutrition Examination Survey 1999-2004 were analyzed.
Results
Depending on the definition of MetS used, the mean non–HDL-C concentration among youth with MetS ranged from 144.2 to 155.8 mg/dL, compared with 108.8-109.1 mg/dL in those without MetS (all P < .001). The MetS prevalence ranged from 6.9% to 11.7% in youth with a non–HDL-C concentration of 120–144 mg/dL and from 21.5% to 23.4% in those with a concentration ≥145 mg/dL—both significantly higher than the prevalence of 1.9%-3.4% in youth with a concentration <120 mg/dL (all P < .001). After adjustment for potential confounders, youth with a non–HDL-C concentration ≥120 mg/dL or ≥145 mg/dL were about 3 or 4 times more likely to have MetS compared with those with a non–HDL-C <120 mg/dL or <145 mg/dL (all P < .001).
Conclusions
Fasting non–HDL-C concentration was strongly associated with MetS in US youth. Our results support the use of non–HDL-C thresholds of 120 mg/dL and 145 mg/dL to indicate borderline and high MetS risk, respectively.
Abbreviations: apo, Apolipoprotein; AUC, Area under the curve; BMI, Body mass index; CDC, Centers for Disease Control and Prevention; CRP, C-reactive protein; DBP, Diastolic blood pressure; IDF, International Diabetes Federation; IDL-C, Intermediate-density lipoprotein cholesterol; LDL-C, Low-density lipoprotein cholesterol; MetS, Metabolic syndrome; NCEP/ATP III, Third National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III); NHANES, National Health and Nutrition Examination Survey; Non–HDL-C, Non–high-density lipoprotein cholesterol; PDAY, Pathobiological Determinants of Atherosclerosis in Youth; ROC, Receiver operating curve; SBP, Systolic blood pressure; VLDL-C, Very–low-density lipoprotein cholesterol
The Journal of Pediatrics
Volume 158, Issue 2, February 2011, Pages 201-207
