Ethnic difference in sex gap in high-density lipoprotein cholesterol between Asian Indians and Whites

Abstract

Objective: To study whether low plasma high-density lipoprotein cholesterol (HDL-C) reported in Asian Indians is common in both men and women when compared with whites and whether it is related to increased body mass index (BMI) and plasma triglyceride concentration. Design: We evaluated the lipid profile and prevalence of low HDL-C (<40 mg/dL in men and <50 mg/dL in women) in the following cohorts of normoglycemic 1404 men and 1817 women: Asian Indians living in rural India; urban Chennai, India; and Dallas, TX; and whites living in Dallas, TX. Results: After adjustment for age, BMI, and smoking, HDL-C was not significantly different in Asian Indian men compared with whites. However, Asian Indian women had lower HDL-C compared with white women, and rural Asian Indian women had the lowest HDL-C even in the absence of high triglycerides. Lean Asian Indian women with BMI of less than 23 kg/m2 had higher frequency of low HDL-C compared with lean white women with BMI of less than 25 kg/m2 (72%, 56%, 48%, and 25% in rural, urban, and Dallas Asian Indian and white women, respectively) and lean men (52%, 42%, 28%, and 35% in rural, urban, and Dallas Asian Indian and white men, respectively). Sex differences in HDL-C was estimated as 6.6 ± 0.5 mg/dL for Asian Indians and 15.3 ± 1.1 mg/dL for whites (P < 0.0001 for sex difference in the 2 ethnic groups). Conclusions: Increased prevalence of low HDL-C independently of obesity or hypertriglyceridemia is observed in women but not in men of Asian Indian origin. The sex gap in HDL-C is significantly smaller in Asian Indians compared with whites independent of geographical location.