Plasma lipid, lipoprotein cholesterol, and apoprotein distributions in selected US communities. The Atherosclerosis Risk in Communities (ARIC) Study.

Abstract

The distributions of plasma lipids, lipoproteins, and apoproteins of 14 524 female and male black and white participants 45 to 64 years old in the Atherosclerosis Risk in Communities (ARIC) Study are presented. All specimens were analyzed at a central laboratory. Mean total cholesterol levels increased with increasing age across all ages from 204 to 229 mg/dL (12%) in women and from 208 to 213 mg/dL (2%) in men. Triglyceride levels increased with age in women, remained stable in men, and were higher in whites than blacks. High-density lipoprotein (HDL) cholesterol levels were higher in black and white women (range, 57 to 59 mg/dL) compared with black men (49 to 52 mg/dL) or white men (42 to 43 mg/dL). Cholesterol associated with HDL was distributed in a relatively constant proportion between HDL] (70% to 76%) and HDL 2 (24% to 30%) for all race/sex groups. Low-density lipoprotein (LDL) cholesterol levels increased with age in black (14.7%) and white (17.1%) women and in black (4.4%) and white (3.7%) men; more than 50% of all participants had LDL cholesterol levels > 130 mg/dL. Apoprotein A-I and B levels followed the same trends as HDL cholesterol and LDL cholesterol levels, respectively. Lipoprotein(a) [Lp(a)J levels were twice as high in blacks as in whites, and women's Lp(a) levels were higher than men's Lp(a) levels for each race. Menopause was associated with elevated total cholesterol, LDL cholesterol, apoprotein B, and Lp(a) levels, and hormone replacement medication use in postmenopausal subjects was associated with higher HDL cholesterol, triglyceride, and apoprotein A-I levels and lower LDL cholesterol, apoprotein B, and Lp(a) levels. (Arteriosclerosis and Thrombosis 1993;13:1139-1158) KEYWORDS • epidemiology • sex • lipoproteins • race C ardiovascular diseases are currently the leading causes of death and disability in both women and men in the United States. 12 Epidemiological evidence from more than 40 prospective studies has shown strong independent relations between various classes of cholesterol-containing particles in the plasma and the incidence of coronary heart disease.310 These data, plus additional evidence from animal and cellular research, leave little doubt that plasma lipids, especially cholesterol, are fundamentally involved in the atherogenic process.The Atherosclerosis Risk in Communities (ARIC) Study is a prospective epidemiological study to investigate the etiology of atherosclerosis and its clinical sequelae and variation in cardiovascular risk factors, medical care, and disease by race, sex, geographical community, and time. 11The ARIC Study was designed to recruit 4000 black and white representative individuals between the ages of 45 and 64 in each of four communities. Thus, the ARIC Study provides an opportunity for examining lipid and lipoprotein levels among men, women, blacks, and whites. The last study detailing plasma lipid and lipoprotein distributions among several US communities was performed by the Lipid Research Clinics Program.8 ' 911 At the same time, the National ...

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