title: Racial and Ethnic Heterogeneity in the Association Between Total Cholesterol and Pediatric Obesity.
abstract: Total cholesterol (TC) directly correlates with overweight/obesity, but it remains unclear if this association varies by race and ethnicity. We assessed the association as well as the racial/ethnic heterogeneity in this relationship. Data on 63,863 children were assessed using electronic medical records between 2010 and 2011. A cross-sectional design was utilized with log-binomial regression model and chi-squared statistic to examine the data. Overall, abnormal total cholesterol (ATC) was 7.5% (4812). Significant racial variability in ATC was observed: Black/African American (AA) (7.4%), White (7.0%), Asian (5.1%) and some other race (SOR) children (11.3%), χ² (5) = 141.5, p < 0.0001. Black/AA (34.7%) and SOR children (41.2%) were predominantly overweight/obese, unlike the Asian children, (25.8%), χ² (5) = 324.6, p < 0.0001. The BMI percentile was highest among SOR (69.0 ± 28.6) and Black/AA children (65.2 ± 29.1), but lowest among Asian children (55.7 ± 31.5). A significant racial variability was also observed in weight, with the highest mean among Black/AA children (36.8kg ± 23.0) and the lowest among Asian children (28.7kg ± 16.8), f = 7.2, p < 0.001. Relative to normal TC, children with ATC were 2.6 times as likely to have abnormal BMI, relative risk (RR) =2.60, 99% CI, 2.54-2.68). Compared to non-Hispanic (RR = 2.62, 99% CI, 2.54-2.69), the risk was lower among Hispanics (RR = 2.34, 99%, 2.21-2.48). Among children with ATC, risk for abnormal BMI was highest among Asians, adjusted RR = 2.91, 99% CI, 2.34-3.62), intermediate among AA (ARR = 2.68, 99% CI, 2.59-2.77), but lowest among Whites (ARR = 2.40, 99% CI, 2.39-2.64), and SOR (ARR = 2.33, 99% CI, 2.19-2.50). In a large sample of children, total cholesterol directly correlates with BMI, with an observed racial and ethnic heterogeneity.
authors.affiliation: Nemours/A.I. duPont Children's Hospital, Nemours Office of Health Equity &amp; Inclusion, 2200 Concord Pike, 8th Floor, Wilmington, DE 19803, USA. lhomes@nemours.org.|Biological Sciences Department, University of Delaware, Newark, DE 19711, USA. lhomes@nemours.org.
authors.forename: Laurens
authors.initials: L
authors.lastname: Holmes
authors.affiliation: Nemours/A.I. duPont Children's Hospital, Nemours Office of Health Equity &amp; Inclusion, 2200 Concord Pike, 8th Floor, Wilmington, DE 19803, USA. alahurd@udel.edu.|Biological Sciences Department, University of Delaware, Newark, DE 19711, USA. alahurd@udel.edu.
authors.forename: Alex
authors.initials: A
authors.lastname: LaHurd
authors.affiliation: Biology Department, Gettysburg College, 300 North Washington Street, Gettysburg, PA 17325, USA. wassonemily326@gmail.com.
authors.forename: Emily
authors.initials: E
authors.lastname: Wasson
authors.affiliation: Epidemiology and Biostatistics Department, School of Public Health, University of Maryland-College Park, College Park, MD 20742, USA. lavisha.mcclarin@nemours.org.
authors.forename: Lavisha
authors.initials: L
authors.lastname: McClarin
authors.affiliation: Nemours/A.I. duPont Children's Hospital, Nemours Office of Health Equity &amp; Inclusion, 2200 Concord Pike, 8th Floor, Wilmington, DE 19803, USA. kdabney@nemours.org.
authors.forename: Kirk
authors.initials: K
authors.lastname: Dabney
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D044466:Asian People / Q000706:statistics & numerical data; D001835:Body Weight / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000009:adverse effects* / Q000097:blood*; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D050177:Overweight / Q000503:physiopathology*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
chemical_list: D002784:Cholesterol
keywords: BMI; health disparities; obesity; pediatric; racial heterogeneity; total cholesterol