title: Low-density lipoprotein cholesterol versus particle number in middle school children.
abstract: OBJECTIVE
  To characterize lipids and lipoproteins in a diverse school-based cohort and identify features associated with discordance between low-density lipoprotein cholesterol (LDL-C) and LDL particle (LDL-P).
  
  
  METHODS
  Sixth-grade children enrolled in the HEALTHY trial (n = 2384; mean age 11.3 ± 0.6 years; 54.2% female) were evaluated for standard lipids, lipoprotein particles measured by nuclear magnetic resonance, and homeostatic model of insulin resistance. Characteristics of subgroups with values of LDL-C and LDL-P discordant by >20 percentile units, an amount reasoned to be clinically significant, were compared.
  
  
  RESULTS
  Four-hundred twenty-eight (18%) of children were in the LDL-P < LDL-C subgroup and 375 (16%) in the LDL-P > LDL-C subgroup. Those with LDL-P > LDL-C had significantly greater body mass index, waist circumference, homeostatic model of insulin resistance, triglycerides, systolic and diastolic blood pressure, and reflected a greater Hispanic ethnic composition but fewer of black race than both the concordant (LDL-P ≅ LDL-C) and opposite discordant (LDL-P < LDL-C) subgroups.
  
  
  CONCLUSIONS
  There is as much lipoprotein cholesterol compositional heterogeneity in sixth graders as has been described in adults and a discordant atherogenic phenotype of LDL-P > LDL-C, common in obesity, is often missed when only LDL-C is considered. Conversely, many children with moderate-risk cholesterol measures (75th to 99th percentile) have a lower LDL-P burden.
authors: George Washington University School of Medicine & Health Sciences, Children's National Medical Center, Washington, DC, USA.
authors: Michele
authors: M
authors: Mietus-Snyder
authors: Kimberly L
authors: KL
authors: Drews
authors: James D
authors: JD
authors: Otvos
authors: Steven M
authors: SM
authors: Willi
authors: Gary D
authors: GD
authors: Foster
authors: Russell
authors: R
authors: Jago
authors: John B
authors: JB
authors: Buse
mesh_terms: D002648:Child; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D010316:Particle Size
chemical_list: D008078:Cholesterol, LDL; D008077:Lipoproteins, LDL
keywords: Apolipoprotein B; BMI; Body mass index; CVD; Cardiovascular disease; HDL-C; HDL-P; HOMA-IR; High-density lipoprotein cholesterol; High-density lipoprotein particle; Homeostatic model of insulin resistance; LDL; LDL-C; LDL-P; Low-density lipoprotein; Low-density lipoprotein cholesterol; Low-density lipoprotein particle; NMR; Nuclear magnetic resonance; TC; TG; Total cholesterol; Triglycerides; VLDL; VLDL-P; Very-low-density lipoprotein; Very-low-density lipoprotein particle; apoB