Ethnic differences in HDL quantity, quality, and potential associations with coronary heart disease risk

Area of Science:

• Cardiovascular Health
• Metabolomics
• Health Disparities

Background:

• Ethnic disparities in coronary heart disease (CHD) risk exist.
• High-density lipoprotein cholesterol (HDL-c) levels and subfractions may influence these disparities.
• The clinical significance of HDL-c and its variations across ethnic groups requires clarification.

Purpose of the Study:

• To investigate ethnic differences in HDL cholesterol (HDL-c) quantity and quality.
• To examine the association of HDL measures with CHD risk across different ethnic groups.
• To determine the impact of sociodemographic, clinical, adiposity, and physical activity factors on these associations.

Main Methods:

• Analysis of HDL-c and ten HDL metabolomic measures in UK Biobank participants.
• Cox proportional hazards models stratified by ethnicity to assess CHD risk.
• Linear regression to evaluate ethnic differences in HDL-c, with sequential adjustments for covariates.

Main Results:

• HDL-c concentrations were lower in South Asian and Black participants compared to White participants, with differences attenuated by adiposity and physical activity.
• HDL-c was inversely associated with CHD risk across all ethnicities, showing the strongest association in South Asians.
• Specific HDL subfractions, like large HDL particles and average HDL diameter, demonstrated stronger inverse associations with CHD in South Asian individuals.

Conclusions:

• Observed ethnic differences in HDL-c are primarily attributable to variations in physical activity and adiposity.
• HDL quantity and quality metrics may be more potent predictors of CHD risk in South Asian individuals.
• Further research is needed to understand the clinical and biological utility of HDL measures in diverse populations.