High-Density Lipoprotein Cholesterol Levels in Middle-School Children: Association with Cardiovascular Risk Factors and Lifestyle Behaviors
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Abstract
To examine factors associated with low high-density lipoprotein cholesterol (HDL-C) levels among middle school children. HDL-C levels were the primary outcome of interest. A total of 1,104 middle-school children (mean age 11.6 years, 51.2 % female) were included in this analysis, of whom 177 (16 %) had an HDL-C level ≤40 mg/dL. More than half of those with low HDL-C were overweight or obese (62.2 %) and had greater systolic and diastolic blood pressure, triglyceride (TRG) levels, and low-density lipoprotein cholesterol levels compared with children with an HDL-C level >40 mg/dL. Among those with an HDL-C ≤ 40 mg/dL, 35 % also had body mass index ≥85 % and TRG levels ≥150 mg/dL. Exercise habits were significantly associated with HDL-C level, whereas sedentary behaviors, such as screen time, were not significantly associated with HDL-C level. Fruit and vegetable intake was also not significantly associated with HDL-C level. Children with low HDL-C levels are more likely to be overweight and to have other physiological indicators of increased cardiovascular risk. Further research is needed to determine if school-based interventions can result in long-term improvements in HDL-C.
Keywords
Childhood obesity Diet Physical activity Cardiovascular risk factors Community healthAbbreviations
- AAP
American Academy of Pediatrics
- ANOVA
Analysis of variance between groups
- BMI
Body mass index
- CARDIAC
Coronary Artery Risk Detection Education Program in Appalachian Communities
- CHD
Coronary heart disease
- GLU
Glucose
- HDL
High density lipoprotein
- HDL-C
High density lipoprotein cholesterol
- IDF
International Diabetes Federation System
- LDL
Low density lipoprotein
- LDL-C
Low density lipoprotein cholesterol
- NCEP III
National cholesterol Education Program
- PHS
Project Healthy Schools
- SPAN
School Physical Activity and Nutrition
- TC
Total cholesterol
- TRG
Triglycerides
- UMHS
University of Michigan Health System
Notes
Acknowledgments
The authors thank the Ann Arbor and Ypsilanti School Boards and administration for their cooperation and participation in this research and the support of the following: the Ann Arbor Area Community Foundation, Southeast Michigan Community Foundation, Hewlett Foundation, Mardigian Foundation, and Thompson Foundation. PHS’ wellness efforts have been generously supported by a number of health systems, foundations, and individuals, including the following: UMHS, Memorial Healthcare Foundation, William Beaumont Health System Foundation, Robert C. Atkins Foundation, Allen Foundation, AstraZeneca Healthcare Foundation, and Robert Beard Foundation.
Conflict of interest
The authors have no potential conflicts of interest.
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