Levels of lipids and apolipoproteins in three cultures

A complete lipoprotein profile requires measurement of the major plasma apolipoproteins-apoB and apoA-I-in addition to measurement of the major plasma and lipoprotein lipids. The objective of this study was to demonstrate the additional information that can be acquired by comparing the major plasma lipids and apolipoproteins amongst adult male and female Swedes, Iranians and Americans.

Data on Iranians were derived from the Isfahan Healthy Heart Program, a prospective community-based sample of 12,103 individuals >20 years of age. Data on Swedes were derived from the AMORIS study, a prospective epidemiological study of 173,629 subjects. Data on Americans were derived from the NHANES III, data bank, which is designed to be representative of the adult American population. Lipids were measured by conventional methods. ApoB and apoA-I were measured by IFCC/WHO standardized methods.

There is a complex pattern of differences amongst the cultures. There are also important similarities in the differences between the genders. Swedes have the highest levels of LDL-C (3.77 mmol/L), apoB (1.27 g/L) and HDL-C (1.53 mmol/L) but the lowest levels of triglyceride (1.47 mmol/L for the Swedes vs. 1.55 mmol/L and 1.93 mmol/L for the Americans and Iranians, respectively, all p<0.001). Americans have higher levels of LDL-C than Iranians (3.26 mmol/L vs. 3.09 mmol/L, p<0.001) but lower levels of apoB (1.04 g/L vs. 1.14 g/L, p<0.001). The absolute values for both HDL-C and apoA-I are higher in females than males of all three cultures throughout the population distribution. The levels of the atherogenic lipoproteins peak between 30 and 40 in males but continue to rise in females. The apoB/apoA-I ratio is highest in the Swedes (0.92, p<0.001) but similar in the Americans and Iranians (0.81 and 0.80, respectively, p NS). By contrast, the TC/HDL-C ratio is highest in the Iranians, intermediate in the Americans and lowest in the Swedes (4.41 vs. 4.36 vs. 4.22, all p<0.001). These data provide further evidence that complete characterization of lipoproteins requires measurement of apoB and apoA-I as well as lipoprotein lipids and that the changes in plasma lipoproteins over time differ between the genders.