RESUMO
Elevated levels of lipoprotein(a) [Lp(a)] are associated with increased risk for coronary heart disease (CHD). However, racial differences in both Lp(a) levels and their associated CHD risk are observed, with African Americans having, on average, higher Lp(a) levels than US whites but not the expected increase in CHD risk. We determined Lp(a) levels and their correlates in a large cohort (n = 2379) of black and white girls, ages 9 to 10 years, at the baseline visit of a longitudinal study of obesity development, the National Heart, Lung, and Blood Institute Growth and Health Study. Lp(a) levels were available for 1269 girls. The median Lp(a) level in black girls was over 3-fold higher than that in white girls. Associations were examined between Lp(a) levels and low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, apolipoprotein B, triglycerides, adiposity, pubertal maturation stage, body fat patterning (triceps/truncal skinfold ratio), and dietary fat (Keys' score). In black girls multiple regression analysis identified LDL-C (P <.001) and adiposity (P =. 08) as predictors of Lp(a) levels. In white girls only LDL-C (P =. 02) was associated with Lp(a). In conclusion, the level of Lp(a) was significantly higher in black girls. Our study also revealed a racial difference in correlates of Lp(a), such as LDL-C and adiposity. Whether this racial difference is due to an underlying biologic difference or is merely a reflection of a greater statistical power to detect a relationship with the level, which was 2.5-fold higher in black girls than in white girls, needs further investigation.
Assuntos
População Negra , Lipoproteína(a)/sangue , População Branca , Análise de Variância , Antropometria , Criança , Comportamento Alimentar , Feminino , Humanos , Estudos Longitudinais , Análise de Regressão , Maturidade Sexual , Estatísticas não Paramétricas , Estados UnidosRESUMO
OBJECTIVE: To evaluate racial differences in blood pressure in girls aged 9 to 10 years in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) and to evaluate the extent to which racial differences in blood pressure are explained by other factors, including sexual maturation and body size. METHODS: The NGHS enrolled 539 black and 616 white girls aged 9 years, and 674 black and 550 white girls aged 10 years. Racial differences in blood pressure were examined. Relationships of stage of sexual maturation, height, and skinfold thickness with systolic and diastolic blood pressure were evaluated by multiple regression analysis. RESULTS: The black girls had significantly higher systolic (102.0 +/- 8.90 vs 100.5 +/- 9.42 mm Hg, p <0.001) and diastolic (58.0 +/- 12.0 vs 56.5 +/- 12.51 mm Hg, p <0.01) blood pressures than the white girls. The black girls were also more advanced in sexual maturation and were taller (142.9 +/- 7.94 vs 139.6 +/- 7.05, p <0.001) and heavier (39.6 +/- 11.24 vs 35.3 +/- 8.73 kg, p <0.001) than the white girls. Both systolic and diastolic blood pressure were significantly correlated with level of maturation, height, weight, and sum of skinfolds. Stage of maturation was found to account for the difference in blood pressure between black girls and white girls. In a multiple regression analysis, controlling for height (for diastolic blood pressure) and for both height and sum of skinfolds (for systolic blood pressure) eliminated the effects of race and stage of maturation on blood pressure. CONCLUSION: Racial differences in blood pressure were observed for 9- and 10-year-old girls and are explained by the fact that black girls were more mature than white girls. The effect of sexual maturation on blood pressure appears to operate through height and body fat. The effect of obesity may be more important for systolic than for diastolic blood pressure. Continuation of racial differences in blood pressure may result in a higher prevalence of hypertension for black women.