Low HDL-cholesterol with normal triglyceride levels is the most common lipid pattern in West Africans and African Americans with Metabolic Syndrome: Implications for cardiovascular disease prevention

Abstract

Background Although designed to predict cardiovascular disease and type 2 diabetes mellitus, the Metabolic Syndrome (MetSyn) under-predicts these conditions in African-Americans (AA). Failure of MetSyn in AA is often attributed to their relative absence of hypertriglyceridemia. It is unknown if the African experience with MetSyn will be similar or different to that in AA. Focusing on the lipid profile, our goal was to determine in West Africans (WA) and AA the pattern of variables that leads to the diagnosis of the MetSyn. Methods Cross-sectional analysis of 1296 subjects (364 WA, 44% male, 932 AA, 46% male). WA were from urban centers in Nigeria and Ghana and enrolled in the Africa America Diabetes Mellitus Study. AA lived in Washington, DC and participated in the Howard University Family Study. Results The prevalence of MetSyn was different in WA women and men: 42% vs.19%, P<0.001, and in AA women and men: 25% vs.17%, P<0.01. The three variables that most often led to the diagnosis of MetSyn in WA and AA were: low HDL-C, central obesity and hypertension. Less than 40% of AA and less than 25% of WA with the MetSyn had hypertriglyceridemia. Conclusions Elevated triglyceride levels were uncommon in both WA and AA with MetSyn. As the relative absence of hypertriglyceridemia is associated with a lack of efficacy of MetSyn in AA, caution is warranted in diagnosing MetSyn in WA, the ancestral population of AA. Prospective studies are necessary to determine if an ethnic-specific reformulation of the MetSyn scoring system for lipids might optimize risk identification in black populations.

Sex Differences in Cardiovascular Disease Risk of Ghanaian‐ and Nigerian‐Born West African Immigrants in the United States: The Afro‐Cardiac Study

“…A third of participants had high LDL‐C, high TC, and low HDL‐C, whereas 1 in 10 had high TG levels. Although persons of African descent typically exhibit a favorable lipid profile characterized by high HDL‐C levels,62, 63 it is unlikely that this atheroprotective trait will persist in WAI with the acquisition of other CVD risk factors and increased years of US residence 64. Elevated TG levels were relatively absent in this group, despite the high prevalence of central adiposity; therefore, the traditional definition of metabolic syndrome, which relies on 5 metabolic risk factors—central adiposity, high TG, low HDL‐C, high blood pressure, and high fasting blood glucose—may underestimate the CVD risk of WAI.…”

The double burden of malnutrition and cardiometabolic risk widens the gender and socio-economic health gap: a study among adults in Burkina Faso (West Africa)

“…The low prevalence of hypertriacylglycerolaemia and the rather high prevalence of low HDL-C in our study are noteworthy and consistent with previous studies in Benin (West Africa) (41,42) . An extensive review on the African diaspora in the UK (47) and a recent study including West Africans and African Americans (48) reported a lower propensity of African people to adverse blood lipid profile. However, low HDL-C was rare in the diaspora, which suggests that lifestyle patterns including diet may explain this difference, considering that West Africans are the ancestors of African Americans who have as much as 70 % of their gene pool of West African origin (49) .…”

Performances comparées du HDL-cholestérol et du ratio cholestérol total/HDL pour le dépistage du syndrome métabolique chez des adultes du Sud-Bénin (Afrique de l’Ouest)

“…Selon Sumner et al (2010), le HDL-C bas représente la dyslipidémie la plus répandue chez les Africains subsahariens. Cette baisse des taux de HDL-C peut être attribuée au mode de vie, l'alimentation et une espérance de vie plus longue (Windler et al, 2007).…”

“…Ce paradoxe est attribué aux différences ethniques entre les niveaux de triglycérides et de HDL-C entre les Afro-Américains et les Caucasiens. Parmi les individus Ouest Africains avec SMet, moins de 25% présentent des concentrations élevées de triglycérides (Sumner, 2010). Sossa et al(2013a) ont rapporté que la prévalence du HDL-C bas était indépendante de l'insulinorésistance.…”