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Int. J. Environ. Res. Public Health 2016, 13(1), 19;

Racial and Ethnic Heterogeneity in the Association Between Total Cholesterol and Pediatric Obesity

Nemours/A.I. duPont Children’s Hospital, Nemours Office of Health Equity & Inclusion, 2200 Concord Pike, 8th Floor, Wilmington, DE 19803, USA
Biological Sciences Department, University of Delaware, Newark, DE 19711, USA
Biology Department, Gettysburg College, 300 North Washington Street, Gettysburg, PA 17325, USA
Epidemiology and Biostatistics Department, School of Public Health, University of Maryland-College Park, College Park, MD 20742, USA
Author to whom correspondence should be addressed.
Academic Editors: Mark Edberg, Barbara E. Hayes, Valerie Montgomery Rice and Paul B. Tchounwou
Received: 14 August 2015 / Revised: 8 November 2015 / Accepted: 16 November 2015 / Published: 23 December 2015
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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. View Full-Text
Keywords: racial heterogeneity; total cholesterol; pediatric; health disparities; obesity; BMI racial heterogeneity; total cholesterol; pediatric; health disparities; obesity; BMI

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Holmes, L.; LaHurd, A.; Wasson, E.; McClarin, L.; Dabney, K. Racial and Ethnic Heterogeneity in the Association Between Total Cholesterol and Pediatric Obesity. Int. J. Environ. Res. Public Health 2016, 13, 19.

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