Non hdl cholesterol reference range

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Non-HDL Cholesterol Reference Range: Insights from Recent Studies

Introduction to Non-HDL Cholesterol

Non-high-density lipoprotein cholesterol (non-HDL-C) is a critical marker for cardiovascular risk assessment. It includes all cholesterol contained in lipoprotein particles that are considered atherogenic, such as low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), and intermediate-density lipoprotein (IDL). Understanding the reference ranges for non-HDL-C is essential for effective risk stratification and management of cardiovascular diseases.

Age and Sex-Specific Reference Ranges

Japanese Children and Adolescents

A study involving 441,431 Japanese schoolchildren aged 9-16 years established age- and sex-specific reference ranges for non-HDL-C. 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. The median non-HDL-C levels in boys decreased from 104 mg/dL at age 9 to 96 mg/dL at age 15, while in girls, the median level remained around 105 mg/dL across all ages .

Korean Children and Adolescents

In a study of 6,197 Korean children and adolescents aged 10-19 years, the overall mean non-HDL-C level was 105.5 mg/dL. Boys had a mean level of 103.3 mg/dL, and girls had 107.9 mg/dL. The median non-HDL-C levels varied with age, showing a decrease in boys from 111 mg/dL at age 10 to 95 mg/dL at age 15, and then an increase to 109 mg/dL by age 19. In girls, the levels were 112 mg/dL at age 10, 103 mg/dL at age 15, and 103 mg/dL at age 19 .

Nordic Adults

The Nordic Reference Interval Project (NORIP) provided age- and sex-specific reference intervals for non-HDL-C in adults. The study highlighted that non-HDL-C levels differ significantly between sexes and across different age groups, emphasizing the need for tailored reference ranges .

U.S. Adults

A large-scale study involving 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 suggested that current non-HDL-C cutpoints might need adjustment to better align with LDL-C percentiles, especially in high-risk patients .

Ethnic and Socioeconomic Variations

U.S. Population

Data from the Third National Health and Nutrition Examination Survey (NHANES III) indicated significant variations in non-HDL-C levels by gender, ethnicity, and education level. Men had higher non-HDL-C levels than women, and black individuals had lower levels compared to Mexican-American and white individuals. Additionally, women with less education had higher non-HDL-C levels .

Botswana Adults

In Botswana, reference intervals for non-HDL-C were established for an urban and peri-urban population. The study found non-HDL-C levels ranging from 1.22 to 4.48 mmol/L, highlighting the importance of regional reference ranges .

Pediatric Reference Intervals

The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) provided non-fasting reference intervals for non-HDL-C in children. The study emphasized the need for age- and sex-specific reference intervals due to significant variations in lipid levels during childhood and adolescence .

Conclusion

Non-HDL cholesterol is a valuable marker for cardiovascular risk assessment, with reference ranges varying significantly by age, sex, ethnicity, and socioeconomic status. Tailored reference intervals are crucial for accurate risk stratification and management, particularly in pediatric and high-risk populations. Understanding these variations can aid in better clinical decision-making and improved cardiovascular outcomes.

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Most relevant research papers on this topic

Reference Ranges for the Non-High-Density Lipoprotein Cholesterol Levels in Japanese Children and Adolescents.

Non-HDL-C levels in Japanese children vary by age and sex, providing valuable tools for managing atherosclerosis prevention in childhood.

Observational StudyVery Rigorous Journal

2015·

25citations

·Yuriko Abe et al.

Reference Values for The Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Non-High-Density Lipoprotein Cholesterol in Korean Children and Adolescents: The Korean National Health and Nutrition Examination Surveys 2007–2013

Age- and gender-specific reference values for non-HDL-C and TG/HDL-C ratio in children and adolescents can help guide individualized lipid profile interpretation and strategies for preventing and managing dyslipidemia.

Observational StudyRigorous Journal

2016·

40citations

·Y. Shim et al.

Non-high-density lipoprotein cholesterol, guideline targets, and population percentiles for secondary prevention in 1.3 million adults: the VLDL-2 study (very large database of lipids).

Non-HDL-C cutpoints for high-risk patients may need to be lowered to match LDL-C cutpoints, as current non-HDL-C levels may lead to significant reclassification to higher treatment categories.

Observational StudyVery Rigorous Journal

2013·

61citations

·M. Elshazly et al.

Age- and sex-specific reference values for non-HDL cholesterol and remnant cholesterol derived from the Nordic Reference Interval Project (NORIP)

Age- and sex-specific reference intervals should be used for non-HDL-cholesterol and remnant cholesterol, which may provide valuable information on cardiovascular risk beyond LDL-cholesterol.

Observational Study

2019·

8citations

·P. Ridefelt et al.

Population frequency distribution of non-high-density lipoprotein cholesterol (Third National Health and Nutrition Examination Survey [NHANES III], 1988-1994).

Non-HDL cholesterol levels vary significantly by gender, age, ethnicity, and education level, with black women and men having lower levels than Mexican-American or white individuals.

Observational StudyHighly Cited

2000·

103citations

·Christopher D. Gardner et al.

Age-and sex-specific reference intervals of total cholesterol, LDL cholesterol, HDL cholesterol and non-HDL cholesterol. Comparison of two algorithms for the indirect estimation of reference intervals

Age- and sex-specific reference intervals for total cholesterol, LDL cholesterol, HDL cholesterol, and non-HDL cholesterol should be established.

2023·

2citations

·R. Haeckel et al.

Non-HDL cholesterol goal attainment and its relationship with triglyceride concentrations among diabetic subjects with cardiovascular disease: A nationwide survey of 2674 individuals in Hungary.

Non-HDL cholesterol goal attainment is suboptimal in people with diabetes and co-existing CVD, with higher triglyceride levels being more significant.

Observational Study

2015·

24citations

·L. Márk et al.

Reference intervals for serum total cholesterol, HDL cholesterol and non-HDL cholesterol in Batswana adults.

In Batswana adults, the reference intervals for total cholesterol, non-HDL cholesterol, and HDL cholesterol are 2.16-5.52 mmol/l for males and 0.67-1.65 mmol/l for females.

Observational Study

2011·

10citations

Pediatric reference intervals for calculated LDL cholesterol, non-HDL cholesterol, and remnant cholesterol in the healthy CALIPER cohort.

Age- and sex-specific reference intervals and appropriate clinical decision limits are necessary for pediatric lipid monitoring, as there is a high prevalence of hyperlipidemia in seemingly healthy children.

Observational Study

2018·

10citations

·V. Higgins et al.

National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: a pooled analysis of 458 population-based studies in Asian and Western countries.

HDL cholesterol has risen and the total-to-HDL cholesterol ratio has declined in many Western countries, Japan, and South Korea, with only a weak correlation with total cholesterol or non-HDL cholesterol changes.

Meta-Analysis

2019·

44citations

·C. Taddei et al.

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