Low-Density Lipoprotein Cholesterol versus Particle Number in Middle School Children

Michele Mietus-Snyder, Kimberly L. Drews*, James D. Otvos, Steven M. Willi, Gary D. Foster, Russell Jago, John B. Buse, HLTH Study Grp

*Corresponding author for this work

    Research output: Contribution to journalArticle (Academic Journal)

    26 Citations (Scopus)


    Objectives To characterize lipids and lipoproteins in a diverse school-based cohort and identify features associated with discordance between low-density lipoprotein cholesterol (LDL-C) and LDL particle (LDL-P).

    Study design Sixth-grade children enrolled in the HEALTHY trial (n = 2384; mean age 11.3 +/- 0.6 years; 54.2% female) were evaluated for standard lipids, lipoprotein particles measured by nuclear magnetic resonance, and homeostatic model of insulin resistance. Characteristics of subgroups with values of LDL-C and LDL-P discordant by >20 percentile units, an amount reasoned to be clinically significant, were compared.

    Results Four-hundred twenty-eight (18%) of children were in the LDL-P <LDL-C subgroup and 375 (16%) in the LDL-P > LDL-C subgroup. Those with LDL-P > LDL-C had significantly greater body mass index, waist circumference, homeostatic model of insulin resistance, triglycerides, systolic and diastolic blood pressure, and reflected a greater Hispanic ethnic composition but fewer of black race than both the concordant (LDL-P congruent to LDL-C) and opposite discordant (LDL-P <LDL-C) subgroups.

    Conclusions There is as much lipoprotein cholesterol compositional heterogeneity in sixth graders as has been described in adults and a discordant atherogenic phenotype of LDL-P > LDL-C, common in obesity, is often missed when only LDL-C is considered. Conversely, many children with moderate-risk cholesterol measures (75th to 99th percentile) have a lower LDL-P burden.

    Original languageEnglish
    Pages (from-to)355-364
    Number of pages10
    JournalJournal of Pediatrics
    Issue number2
    Publication statusPublished - Aug 2013


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