Correlates of serum lipoprotein (A) in children and adolescents in the United States. The third National Health Nutrition and Examination Survey (NHANES-III)

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Abstract

Objective

To determine the correlates of serum lipoprotein (a) (Lp(a)) in children and adolescents in the United States.

Methods

Cross-sectional study using representative data from a US national sample for persons aged 4–19 years participating in The Third National Health Nutrition and Examination Survey (NHANES-III).

Results

We observed ethnicity-related differences in levels of Lp(a) > 30 mg/dl, with values being markedly higher in African American (black) than nonhispanic white (white) and Mexican American children in multivariate model ( P < 0.001). Higher levels of Lp(a) > 30 mg/dl associated with parental history of body mass index and residence in metro compared to nonmetro in Blacks, and high birth weight in Mexican American children in the NHANES-III. In the entire group, total cholesterol (which included Lp(a)) and parental history of premature heart attack/angina before age 50 ( P < 0.02) showed consistent, independent, positive association with Lp(a). In subgroup analysis, this association was only evident in white ( P = 0.04) and black ( P = 0.05) children. However, no such collective consistent associations of Lp(a) were found with age, gender, or birth weight.

Conclusion

Ethnicity-related differences in mean Lp(a) exist among children and adolescents in the United States and parental history of premature heart attack/angina significantly associated with levels of Lp(a) in children. Further research on the associations of Lp(a) levels in childhood with subsequent risk of atherosclerosis is needed.

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Most cited references 41

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Aerobic physical activity effects on psychological well-being in low-income Hispanic children.

D Landers, D Crews, Marc R Lochbaum (2004)

Psychological well-being has been generally associated with vigorous aerobic activity and structured aerobic activity in adolescents and children. Low-income children are at greater risk than the general population for experiencing high environmental stress and increased mental health problems. This study investigated the effects of a structured physical fitness program on psychological well-being in low-income Hispanic children. A total of 66, 33 girls, 33 boys, in Grade 4 were randomly assigned to either an Aerobic intensity (n = 34) or a Control intensity physical activity program (n = 32) for 6 wk. Psychological well-being was defined as scores on trait anxiety, depression, and self-esteem, measured, respectively, by the Trait Anxiety Inventory, Beck Depression Inventory, and Rosenberg Self-esteem scale. Analysis showed the children in the Aerobic intensity program significantly (p < .05) improved their cardiovascular fitness as measured by the PWC170 test. After the program was over, the children in this Aerobic group reported significantly (p < .05) less depression. The main effect for self-esteem reflected the Aerobic group's greater self-reported self-esteem. No differences were found on trait anxiety. The effects on depression and self-esteem may only be attributed to the cardiovascular improvement given the higher intensity physical activity program because causation was not assessed here.

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Lipoprotein(a) as a risk factor for ischemic heart disease: metaanalysis of prospective studies.

J Haddow, Glenn E. Palomaki, L M Neveux … (1998)

Although in vitro studies support a pathophysiologic role for lipoprotein(a) [Lp(a)] in the development of atherosclerosis, and retrospective studies consistently report that there is a relationship between Lp(a) and ischemic heart disease (IHD), the conclusions drawn from prospective studies about this relationship have been inconsistent. To address this issue, we have performed a metaanalysis of data available from prospective studies. Lp(a) concentrations expressed as mass units vary markedly between studies, reflecting the need for assay standardization. In 12 of 14 prospective studies, Lp(a) concentrations are higher in subjects who later develop IHD (cases) than in those who do not (controls), although there is variation in the size of the effect. Sample storage temperature may contribute to this variability. When the studies are analyzed collectively, Lp(a) concentrations are significantly higher in cases than in controls, and the extent of the effect is similar in men and women. These findings provide evidence in support of a causal role for Lp(a) in the development of atherosclerosis. Measurement of Lp(a) may be useful to guide management of individuals with a family history of IHD or with existing disease. The separation in values between cases and controls is not, however, sufficient to allow the use of Lp(a) as a screening test in the general population.

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Ethnic differences in fibrinogen levels: the role of environmental factors and the beta-fibrinogen gene.

Bruce Cook, E R Nakandakare, F Cappuccio … (2001)

Fibrinogen is a cardiovascular risk factor, but little is known about levels in ethnic groups that differ in their cardiovascular risk. Fibrinogen was measured in 479 Black individuals, 459 South Asian Indians, and 453 Whites aged 40-59 years living in south London, England, from March 1994 to July 1996. Genotype was determined at two sites in the promoter of the beta-fibrinogen gene (G-455-->A and C-148-->T). Plasma fibrinogen levels were lower in Blacks than in Whites by 0.22 g/liter (95% confidence interval (CI): 0.08, 0.36) in men and 0.11 g/liter (95% CI: -0.01, 0.23) in women. These differences were not explained by measured environmental variables, including smoking, or by genotypes. The fibrinogen levels of South Asians were not consistently different from those of WHITES: The A-455 and T-148 alleles were less common in Blacks than in either Whites or South ASIANS: In Whites and South Asians, but not in Blacks, there was complete allelic association between the two variants. In Blacks, the T allele rather than the A allele was associated with higher fibrinogen levels. The average fibrinogen-raising effect of the T-148 allele across all ethnic groups was 0.14 g/liter (95% CI: 0.02, 0.26 g/liter) in women and 0.15 g/liter (95% CI: 0.03, 0.27 g/liter) in men. Low fibrinogen levels in Blacks may partly explain their lower risk of ischemic heart disease in the United KINGDOM:

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Author and article information

Journal

Journal ID (nlm-ta): Lipids Health Dis

Title: Lipids in Health and Disease

Publisher: BioMed Central (London )

ISSN (Electronic): 1476-511X

Publication date Collection: 2004

Publication date (Electronic): 16 December 2004

Volume: 3

Page: 29

Affiliations

[1 ]Section of Geriatrics, Department of Medicine, Howard University Hospital, Washington, USA

[2 ]Department of Epidemiology, University of Alabama at Birmingham, USA

[3 ]Department of Human Health & Leisure Studies, Howard University, Washington, USA

[4 ]Institute for Women's Health, Howard University Hospital, Washington, USA

[5 ]National Human Genome Center Genetic Epidemiology Unit, Department of Microbiology, Howard University, Washington, USA

Article

Publisher ID: 1476-511X-3-29

DOI: 10.1186/1476-511X-3-29

PMC ID: 544891

PubMed ID: 15601478

SO-VID: 0729653d-6308-415b-ac16-77e3f1b3266e

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Correlates of serum lipoprotein (A) in children and adolescents in the United States. The third National Health Nutrition and Examination Survey (NHANES-III)

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Abstract

Objective

Methods

Results

Conclusion

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GLUT4 biology

Most cited references 41

Aerobic physical activity effects on psychological well-being in low-income Hispanic children.

Lipoprotein(a) as a risk factor for ischemic heart disease: metaanalysis of prospective studies.

Ethnic differences in fibrinogen levels: the role of environmental factors and the beta-fibrinogen gene.

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