Optimal high-density lipoprotein cholesterol cutoff for predicting cardiovascular disease: Comparison of the Korean and US National Health and Nutrition Examination Surveys

Abstract

Serum high-density lipoprotein cholesterol (HDL-C) has been reported to be lower in Asians than in Caucasians. We compared HDL-C levels between the Korean and US populations using stratified analysis according to age and sex and estimated the optimal cutoff value for HDL-C that best predicts the risk of cerebrovascular accidents (CVAs) and ischemic heart disease (IHD) in Koreans. The Korean National Health and Nutrition Examination Survey (KNHANES) 2010-2012 and the National Health and Nutrition Examination Survey (NHANES) 2011-2012 were used for the Korean and US populations, respectively. HDL-C levels were compared using general linear models. To estimate the optimal HDL-C cutoff value that predicts CVAs and IHD, sensitivity and specificity of different HDL-C levels were calculated. The mean HDL-C level was significantly lower in KNHANES in both sexes (46.1 [standard error, 0.2] mg/dL in KNHANES and 47.7 [0.5] mg/dL in NHANES, P = .003 in men, and 51.2 [0.2] mg/dL in KNHANES and 58.3 [0.8] mg/dL in NHANES, P < .001 in women). The optimal HDL-C cutoff to predict CVA-IHD was 43 mg/dL and 48 mg/dL for Korean men and women, respectively, and 41 mg/dL and 56 mg/dL for US men and women, respectively. HDL-C levels are significantly lower in both sexes in the Korean population than the US population. The optimal cutoff HDL-C value to predict the risk of CVA-IHD was 43 mg/dL for men and 48 mg/dL for women in the Korean population.