Distribution and correlations of non-high-density lipoprotein cholesterol in Roma and Caucasian children: the Slovak Lipid Community Study.

Non-high-density lipoprotein (non-HDL) cholesterol [total cholesterol minus high-density lipoprotein (HDL) cholesterol] is considered a better predictor of coronary heart disease (CHD) risk than low-density lipoprotein (LDL) cholesterol. The Slovak Roma population have approximately 2.5-fold higher premature CHD mortality than the overall population. It is agreed that detection of dyslipidemia and prevention of atherosclerosis by controlling CHD risk factors should begin in childhood. However, only limited population-based data are available for non-HDL cholesterol in children. Hence the aim of the present cross-sectional study has been to determine population frequency data and correlations of non-HDL cholesterol in 788 Roma and Caucasian children (42% Roma, 51% male), aged 7-17, from Central Slovakia, as part of the Slovak Lipid Community Study. Roma children, compared to Caucasians, had higher serum levels of total cholesterol, LDL cholesterol and HDL cholesterol, were less physically active, smoked more, and had lower body mass index and blood pressure (all at p < 0.05). Serum non-HDL cholesterol levels were similar in Roma and Caucasians (in mmol/L: 2.74 vs. 2.65, p = 0.062) and similar too in boys and girls (2.66 vs. 2.73, p = 0.092), but higher in the younger (7-11 yrs.) than in the older (12-17 yrs.) age group (2.77 vs. 2.62, p < 0.001). Non-HDL cholesterol was negatively associated with age and cigarette smoking (r = -0.09 and -0.11 respectively, p < 0.05), whereas general obesity as measured by body mass index, waist circumference and per capita income were positively correlated with non-HDL cholesterol (r = 0.09-0.14, p < 0.05). Intermediate or strong positive correlations were found with other lipid variables under study: triglycerides, total and LDL cholesterol and apoliporotein (Apo) B (r = 0.43-0.93, p < 0.001). No significant association was noted between non-HDL cholesterol and blood pressure, physical activity status, and HDL cholesterol and Apo AI. In a multivariate analysis: body mass index, age and cigarette smoking accounted for 3.3% of the variance in non-HDL cholesterol. The non-HDL cholesterol cut-off points identified as corresponding to the recommended cut-off points of LDL cholesterol for CHD risk assessment and treatment of dyslipidemia in pediatric population were: acceptable < 3.30, borderline 3.31-3.81 and high > or = 3.82 mmol/L. The prevalence of dyslipidemia according to the high non-HDL cholesterol value was 5.4% in Roma and 4.2% in Caucasian children (p = 0.098). In conclusion, our results confirm no ethnic-, gender- or age-related differences in non-HDL cholesterol levels between Slovak Roma and Caucasian children. In both ethnic groups, overweight and obesity and also higher socio-economic status--but not cigarette smoking--are adversely associated with non-HDL cholesterol levels in childhood.