title: Optimal high-density lipoprotein cholesterol cutoff for predicting cardiovascular disease: Comparison of the Korean and US National Health and Nutrition Examination Surveys.
abstract: BACKGROUND
  Serum high-density lipoprotein cholesterol (HDL-C) has been reported to be lower in Asians than in Caucasians.
  
  
  OBJECTIVE
  We compared HDL-C levels between the Korean and US populations using stratified analysis according to age and sex and estimated the optimal cutoff value for HDL-C that best predicts the risk of cerebrovascular accidents (CVAs) and ischemic heart disease (IHD) in Koreans.
  
  
  METHODS
  The Korean National Health and Nutrition Examination Survey (KNHANES) 2010-2012 and the National Health and Nutrition Examination Survey (NHANES) 2011-2012 were used for the Korean and US populations, respectively. HDL-C levels were compared using general linear models. To estimate the optimal HDL-C cutoff value that predicts CVAs and IHD, sensitivity and specificity of different HDL-C levels were calculated.
  
  
  RESULTS
  The mean HDL-C level was significantly lower in KNHANES in both sexes (46.1 [standard error, 0.2] mg/dL in KNHANES and 47.7 [0.5] mg/dL in NHANES, P = .003 in men, and 51.2 [0.2] mg/dL in KNHANES and 58.3 [0.8] mg/dL in NHANES, P < .001 in women). The optimal HDL-C cutoff to predict CVA-IHD was 43 mg/dL and 48 mg/dL for Korean men and women, respectively, and 41 mg/dL and 56 mg/dL for US men and women, respectively.
  
  
  CONCLUSIONS
  HDL-C levels are significantly lower in both sexes in the Korean population than the US population. The optimal cutoff HDL-C value to predict the risk of CVA-IHD was 43 mg/dL for men and 48 mg/dL for women in the Korean population.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Moon
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, Boramae Medical Center, Seoul, Korea.
authors.forename: Bo Kyung
authors.initials: BK
authors.lastname: Koo
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, Boramae Medical Center, Seoul, Korea. Electronic address: mkmoon@snu.ac.kr.
authors.forename: Min Kyong
authors.initials: MK
authors.lastname: Moon
mesh_terms: D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL
keywords: Cerebrovascular accidents; HDL cholesterol; Ischemic heart disease; Korean; National Health and Nutrition Examination Survey