Impact of body mass index levels on lipid abnormalities in Chinese Asians, American Blacks and American Whites: The People's Republic of China (PRC) and Atherosclerosis Risk in Communities (ARIC) Studies

BackgroundSeveral researchers have reported that Chinese adults may have a greater chronic disease burden than Whites, especially at lower body mass index (BMI) levels.ObjectivesTo compare the incidence of lipid abnormalities in Chinese (n = 5303), White (n = 10,752) and Black (n = 3408) middle-aged adults and the effect of BMI on these incidences.MethodsData were from the People's Republic of China (PRC) and the Atherosclerosis Risk in Communities (ARIC) studies. In each ethnic group, we calculated the adjusted cumulative incidence for high total cholesterol (≥240 mg/dL), LDL-cholesterol (≥160 mg/dL), and triglycerides (≥200 mg/dL) and low HDL-cholesterol (≤40 in men and ≤50 mg/dL in women) adjusted for age, gender, education, field site, smoking and drinking status. Risk differences associated with BMI (referent = 18.5-22.9 kg/m2) were calculated using weighted linear regression and slopes compared using the Wald test.ResultsChinese had lower incidence of abnormal total cholesterol, LDL-cholesterol and triglycerides than Whites in most BMI groups and had lower incidence of abnormal HDL-cholesterol and triglycerides than Blacks. Across the range of 18.5 to <30, BMI was more strongly associated with the incidence of having high total cholesterol in Chinese and Whites than in Blacks. Similar trends were seen for LDL-cholesterol and triglycerides, but were not always statistically significant. In contrast, BMI was more highly associated with incidence of low HDL-cholesterol in Whites than in Chinese or Blacks.ConclusionAlthough differences in the incidence of lipid abnormalities and the impact of BMI were identified, results varied by lipid type indicating no consistent ethnic/national pattern.