title: Discordance between high non-HDL cholesterol and high LDL-cholesterol among US adults.
abstract: BACKGROUND
  Although low-density lipoprotein cholesterol (LDL-C) is recommended as the primary marker to guide lipid-lowering therapy, some data suggest non-high-density lipoprotein cholesterol (non-HDL-C) may better reflect coronary heart disease risk. Discordance between these measures has not been evaluated.
  
  
  METHODS
  We used data from the National Health and Nutrition Examination Surveys 2005-2010 (n = 4986) to examine the discordance between these lipid parameters. Elevated levels of non-HDL-C and LDL-C were defined by using the 2004 Adult Treatment Panel III guidelines.
  
  
  RESULTS
  The prevalence of high non-HDL-C and LDL-C was 22.7% and 24.5%, respectively. Of participants with high non-HDL-C, 9.7% had normal LDL-C, whereas 15.7% of participants with high LDL-C had normal non-HDL-C. We estimate 3.9 million US adults had high non-HDL-C and normal LDL-C, whereas 6.8 million US adults had high LDL-C and normal non-HDL-C. Persons with high non-HDL-C and normal LDL-C were older, more likely to be men, Hispanic, and have impaired fasting glucose, diabetes metabolic syndrome, and more risk factors for coronary heart disease.
  
  
  CONCLUSIONS
  Substantial discordance exists between high non-HDL-C and high LDL-C among US adults. Reliance on either single measure could result in failure to classify cardiovascular heart disease risks appropriately.
authors: Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, RPHB 330, Birmingham, AL 35294-0022, USA. Electronic address: mkilgore@uab.edu.
authors: Meredith
authors: M
authors: Kilgore
authors: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors: Paul
authors: P
authors: Muntner
authors: Amgen Corporation, Thousand Oaks, CA, USA.
authors: J Michael
authors: JM
authors: Woolley
authors: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors: Pradeep
authors: P
authors: Sharma
authors: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors: Vera
authors: V
authors: Bittner
authors: Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors: Robert S
authors: RS
authors: Rosenson
mesh_terms: D000328:Adult; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D015995:Prevalence; D014280:Triglycerides / Q000097:blood; D014481:United States / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: Cholesterol screening; Coronary heart disease; Dyslipidemia; Epidemiology; Practice guidelines