Are Hispanic Youth at Higher Risk for Cardiovascular Disease Due to Lower Levels of High-Density Lipoprotein Cholesterol?

Background/Aim: Low levels of high-density lipoprotein (HDL) cholesterol in childhood are associated with an increased incidence of cardiovascular disease (CVD) in adulthood, making early detection of lipid abnormalities important in identifying CVD risk. Studies have shown differences in adult HDL levels between ethnic groups, suggesting that HDL is lower in Hispanic adults compared to Non-Hispanic White (NHW) adults. Since CVD and obesity are increasing in Hispanic adults disproportionately, studies on childhood risk factors affecting HDL are essential but limited. We hypothesize HDL levels differ between Hispanic and NHW children, with ethnicity and body mass index (BMI) as significant predictors of HDL levels. Materials and Methods: The UCHealth Healthy Hearts and Minds Program in Colorado conducted biometric screenings on elementary, middle, and high school students, with 14,532 voluntary HDL assessments from 8/2019 to 1/2024. ANOVA and multivariate linear regression models were used for statistical analysis. Results: HDL averages for Hispanic and NHW students were 46.2 mg/dL and 47.6 mg/dL, respectively (p-value <0.001). Males students had a general trend of decreasing HDL levels with advancing age while females HDL levels remained relatively constant across grade levels. The effect of BMI resulted in ~0.8 mg/dL per BMI unit increase for both sexes while controlling for BMI showed no significant difference in HDL levels between ethnic groups. However, 41.35% of Hispanic students were overweight/obese compared to 22.53% of NHW students, accounting for the perceived mean differences in HDL. Conclusions: Observed differences in mean HDL levels between Hispanic and NHW students were due to the higher prevalence of overweight/obesity in the Hispanic sample.