title: Racial Differences in Blood Lipids Lead to Underestimation of Cardiovascular Risk in Black Women in a Nested observational Study.
abstract: BACKGROUND
  During screening for enrollment in a clinical trial, we noticed potential racial disparities in metabolic syndrome variables in women who responded to our study advertisement. We designed a nested observational study to investigate whether metabolic syndrome variables differed between non-Hispanic blacks and non-Hispanic whites.
  
  
  METHODS
  The cohort comprised of women who have met the preliminary clinical trial criteria (body mass index [BMI] 25-45, age 20-75 years, and no use of lipid-lowering medications or supplements). These women, including 116 blacks and 138 whites, provided fasting blood samples for analysis of serum lipid profile.
  
  
  RESULTS
  Blacks had lower mean triglycerides (81.1 ± 3.3 mg/dL vs 140.6 ± 5.9 mg/dL; P < .0001), total cholesterol (176.1 ± 3.6 mg/dL vs 201.6 ± 3.3 mg/dL; P < .0001), and low-density lipoprotein (111.7 ± 3.3 mg/dL vs 128.2 ± 2.9 mg/dL; P < .001) and higher mean BMI (37.2 ± 0.5 vs 35.2 ± 0.5; P < .01) and diastolic blood pressure (82.4 ± 0.8 mmHg vs 79.4 ± 0.7 mmHg; P < .01) than whites. Only 7% of blacks, compared with 41% of whites, had triglycerides ≥150 mg/dL; as a result, fewer black women met metabolic syndrome criteria than white women. Additionally, in women with waist circumference ≥88 cm (N = 215), high-density lipoprotein was higher in blacks than in whites (48.3 ± 1.5 mg/dL vs 44.2 ±1.3 mg/dL; P < .05).
  
  
  CONCLUSIONS
  Due to racial differences in blood lipids, current metabolic syndrome criteria may result in underestimation of cardiovascular risk in blacks.
authors.affiliation: Department of Emergency Medicine, University of Florida, Jacksonville, United States.
authors.forename: Mark S
authors.initials: MS
authors.lastname: McIntosh
authors.affiliation: Department of Emergency Medicine, University of Florida, Jacksonville, United States.
authors.forename: Vivek
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Emergency Medicine, University of Florida, Jacksonville, United States.
authors.forename: Colleen
authors.initials: C
authors.lastname: Kalynych
authors.affiliation: Department of Emergency Medicine, University of Florida, Jacksonville.
authors.forename: Michelle
authors.initials: M
authors.lastname: Lott
authors.affiliation: Metagenics, Inc, Gig Harbor, Washington, United States.
authors.forename: Alex
authors.initials: A
authors.lastname: Hsi
authors.affiliation: Metagenics, Inc, Gig Harbor, Washington, United States.
authors.forename: Jyh-Lurn
authors.initials: JL
authors.lastname: Chang
authors.affiliation: Metagenics, Inc, Gig Harbor, Washington, United States.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Lerman
keywords: Women; cardiovascular disease; cholesterol; metabolic syndrome; race; triglycerides