Abstract 13783: Paradigms to Predict Cardiometabolic Disease in African Descent Populations Should Focus on HDL-Cholesterol Rather than Triglyceride

Abstract

Paradigms for the early detection of cardiometabolic disease usually incorporate both elevated triglyceride (TG) and low high density lipoprotein -cholesterol (HDL-C). However, African-Americans with cardiometabolic disease usually have normal TG levels. The HDL-C pattern of African-Americans with cardiometabolic disease is uncertain. The TG and HDL-C pattern in Africans with cardiometabolic disease is unknown. To clarify the TG and HDL-C pattern in African descent populations with cardiometabolic disease, 377 blacks (167 African-Americans, 210 African immigrants, 59% male, age 36±9y, mean±SD, range 20-64y, BMI 29.0±6.3 kg/m2, range 18.5-54.7) had glucose tolerance status determined by OGTT, lipid profiles and insulin resistance determined by the insulin sensitivity index (SI). Insulin resistance was defined as the lowest quartile of SI (<2.18 L/mU - 1min- 1). Metabolic triad was defined as hyperinsulinemia (fasting insulin≥3.7 μU/mL), hyperapolipoproteinB (≥64 mg/dL) and sdLDL(≥21.5 nm) based on the median values of the group with normal BMI. Cardiometabolic disease was defined as one or more of the following: pre-diabetes, diabetes, insulin resistance or metabolic triad. The frequency with which hypertriglyceridemia (TG≥150 mg/dL) or low HDL-C (<40 mg/dL in men or <50 mg/dL in women) occurred in the presence of cardiometabolic disease was determined. The prevalence of cardiometabolic disease did not differ in African-Americans and African immigrants (63% vs. 60%, P=0.51). TG and HDL-C levels in blacks with cardiometabolic disease did not differ by African ancestry. In the presence of cardiometabolic disease, TG levels were 80±40 vs. 87±43, P=0.24, resp. while HDL-C levels in men were: 45±11 vs. 44±12, P=0.63, and in women: 48±10 vs. 49±10, P=0.86). Less than 10% of people with cardiometabolic disease had TG≥150 mg/dL. However, 42% of people with cardiometabolic disease had low HDL-C. If HDL-C levels were low, the odds of having cardiometabolic disease was 2.84 (95% CI 1.76, 4.59. P<0.001). Overall, more than 40% of people with cardiometabolic disease had low HDL while <10% had elevated TG levels. Therefore, paradigms to detect cardiometabolic disease in African descent populations should focus on HDL-C rather than TG.