| Title: | Ethnic differences in HDL quantity, quality, and potential associations with coronary heart disease risk |
| Journal: | Atherosclerosis |
| Published: | 1 Nov 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41202738/ |
| DOI: | https://doi.org/10.1016/j.atherosclerosis.2025.120565 |
Publication 19085
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Abstract
BACKGROUND AND AIMS: Ethnic differences in HDL cholesterol (HDL-c) may help explain disparities in coronary heart disease (CHD) risk, but the clinical interpretation of HDL-c and its metabolomic subfractions across populations remains unclear.</p>
METHODS: We examined HDL quantity and quality in relation to ethnicity and CHD risk in UK Biobank. HDL-c and ten metabolomic HDL measures (reflecting particle size and lipid composition) were analyzed in relation to CHD using Cox models stratified by ethnicity. Linear regression assessed differences in HDL-c by ethnicity. Models were sequentially adjusted for sociodemographic, clinical, adiposity, and physical activity variables.</p>
RESULTS: After adjustment, HDL-c concentrations were modestly lower in South Asian (-0.091 mmol/L) and Black (-0.025 mmol/L) participants compared to White participants. These differences were substantially attenuated after further adjustment for adiposity and physical activity. HDL-c was inversely associated with CHD across all ethnic groups, with the strongest association in South Asian (HR per SD: 0.40 [0.29-0.54]) compared with White participants (HR: 0.64 [0.61-0.67]). Several HDL subfractions (particularly large HDL particles and average HDL diameter) showed stronger inverse associations with CHD in South Asian participants compared to other ethnic groups.</p>
CONCLUSIONS: Lower HDL-c concentrations in South Asian and Black vs White participants appear largely driven by differential physical activity and/or adiposity measures. In South Asian individuals, HDL quantity and quality measures may be more strongly predictive of risk, warranting further investigation into their clinical and biological utility in diverse populations.</p>
15 Keywords
- Adult
- Aged
- Asian People
- Biomarkers
- Black People
- Cholesterol, HDL
- Coronary Disease
- Female
- Humans
- Male
- Middle Aged
- Risk Assessment
- Risk Factors
- United Kingdom
- White People
5 Authors
- Sabrina Scilletta
- Paul Welsh
- Jack David Beazer
- Antonino Di Pino
- Naveed Sattar
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