Non hdl c range
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Understanding Non-HDL Cholesterol (Non-HDL-C) Ranges and Their Implications
Non-HDL Cholesterol Reference Ranges in Children and Adolescents
Age and Sex-Specific Ranges
Non-HDL cholesterol (non-HDL-C) levels vary significantly by age and sex in children and adolescents. A study involving 441,431 Japanese schoolchildren aged 9-16 years found that the overall mean non-HDL-C level was 105.7 mg/dL, with boys averaging 103.0 mg/dL and girls 108.2 mg/dL. For boys, the median non-HDL-C level decreased from 104 mg/dL at age 9 to 96 mg/dL at age 15. In contrast, girls maintained a median level of approximately 105 mg/dL across all ages.
Percentile Distributions
The 75th percentile for boys ranged from 120 mg/dL at ages 9-11 to 113 mg/dL at ages 12-15, while the 95th percentile decreased from 150 mg/dL to 140 mg/dL over the same age ranges. For girls, the 75th and 95th percentiles remained steady at approximately 122 mg/dL and 150 mg/dL, respectively.
Non-HDL Cholesterol in Adults
Population Percentiles and Guideline Targets
In adults, non-HDL-C is used as an alternative to LDL-C for risk stratification and lipid-lowering therapy. A study of 1.3 million U.S. adults found that non-HDL-C values corresponding to LDL-C cutpoints of 70, 100, 130, 160, and 190 mg/dL were 93, 125, 157, 190, and 223 mg/dL, respectively. This study highlighted significant discordance between non-HDL-C and LDL-C percentiles, especially at lower LDL-C and higher triglyceride levels, suggesting that current non-HDL-C cutpoints for high-risk patients may need to be lowered.
Predictive Value for Cardiovascular Disease
Non-HDL-C has been shown to be a better predictor of atherosclerotic cardiovascular disease (ASCVD) risk factors than LDL-C, even in individuals with near-normal triglyceride levels. In a Venezuelan study, non-HDL-C levels between 130-159 mg/dL and ≥160 mg/dL were associated with a significantly higher risk of multiple ASCVD risk factors. Additionally, non-HDL-C levels were found to be predictive of adverse outcomes in acute ischemic stroke and were associated with increased risk of recurrent ischemic stroke and all-cause death within one year.
Meta-Analyses and Systematic Reviews
Coronary Heart Disease (CHD) Risk
A meta-analysis involving 448,732 individuals found that higher baseline non-HDL-C levels were associated with a 79% increased risk of coronary heart disease (CHD). This risk was more pronounced in men than in women. Another systematic review indicated that elevated non-HDL-C levels were significantly associated with increased mortality risk in CHD patients, with each 10 mg/dL increase in non-HDL-C correlating with a 13% higher risk of mortality.
Chronic Kidney Disease (CKD)
In patients with non-dialysis chronic kidney disease (ND-CKD), high non-HDL-C levels were linked to an increased risk of adverse cardiovascular outcomes. A study from the Korean Cohort Study for Outcomes in Patients with Chronic Kidney Disease (KNOW-CKD) found that patients in the highest quintile of non-HDL-C had a significantly higher risk of composite cardiovascular events.
Conclusion
Non-HDL cholesterol is a crucial marker for cardiovascular risk assessment across different populations. Its levels vary by age and sex in children and adolescents, and it serves as a more reliable predictor of cardiovascular risk than LDL-C in adults. Elevated non-HDL-C levels are associated with increased risks of CHD, adverse outcomes in stroke, and mortality in CHD and CKD patients. These findings underscore the importance of monitoring non-HDL-C levels for effective cardiovascular risk management.
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