Ethnic Difference in Lipid Profiles

Abstract

Dyslipidaemia is a major cardiovascular disease (CVD) risk factor that plays an important role in the progress of atherosclerosis, the underlying pathology of CVD. To keep lipids and lipoproteins levels within ideal range has been recommended by different national, regional, or global (2001; Graham et al. 2007; World Health Organization 2007) guidelines on the prevention and management of CVD. The prevalence and pattern of lipid disorder, however, differ between ethnicities and populations. As a component of the metabolic syndrome, dyslipidaemia often coexists with diabetes, the coronary heart disease (CHD) risk equivalent. An atherogenic lipid profiles consists of high triglycerides (TG) and small dense low-density lipoprotein cholesterol (LDL-C) and low high-density lipoprotein cholesterol (HDL-C). The importance of dyslipidaemia on risk of CVD in patients with diabetes has been extensively studied in numerous studies. Reduced HDL-C is well documented as an independent predictor of CVD events (Wilson et al. 1988; Cooney et al. 2009). In contrast, the role of TG as an independent risk factor for CVD is more controversial (Patel et al. 2004; Psaty et al. 2004; Barzi et al. 2005; Sarwar et al. 2007; Wang et al. 2007). Recently, the interest to use novel parameters such as total cholesterol (TC) to HDL ratio (TC/HDL-C), non-HDL-cholesterol (non-HDL-C), apolipoprotein B (apoB) and apolipoprotein A (apoA) to assess CVD risk has increased (Barzi et al. 2005; Pischon et al. 2005; Charlton-Menys et al. 2009). As a CVD risk predictor, the non-HDL-C has been considered to be superior to LDL-C (Cui et al. 2001; Schulze et al. 2004; Liu et al. 2005; Ridker et al. 2005). However, there are racial and geographic disparities in lipid profiles not only in general populations but also in individuals with different glucose categories. The Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III) has recommended that certain factors be recognized when clinicians evaluate the lipid profile of different population groups (Adult Treatment Panel III 2002). Although management of lipids using NCEP-ATP III guidelines is applicable to all populations, unique aspects of risk factor profile call for special attention to certain features in different racial/ethnic groups.