African American-white differences in lipids, lipoproteins, and apolipoproteins, by educational attainment, among middle-aged adults: The atherosclerosis risk in communities study

Patricia A. Metcalf, A. Richey Sharrett, Aaron R. Folsom, Bruce B. Duncan, Wolfgang Patsch, Richard G. Hutchinson, Moyses Szklo, C. E. Davis, H. A. Tyroler

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Measures of socioeconomic status have been shown to be related positively to levels of high density lipoprotein (HDL) cholesterol in white men and women and negatively in African American men. However, there is little information regarding the association between educational attainment and HDL fractions or apolipoproteins. The authors examined these associations in 9,407 white and 2,664 African American men and women aged 45-64 years who participated in the Atherosclerosis Risk in Communities Study baseline survey, and they found racial differences. A positive association for HDL cholesterol, its fractions HDL2 and HDL3 cholesterol, and its associated apolipoprotein A-l was found in white men and white women, but a negative association was found in African American men, and there was no association in African American women. In whites, there was also an inverse association of low density lipoprotein (LDL) cholesterol and apolipoprotein B with educational attainment. With the exception of African American men, advanced education was associated with a more favorable cardiovascular lipid profile, which was strongest in white women. Racial differences in total cholesterol (women only), plasma triglycerides, LDL cholesterol, apolipoprotein B (women only), HDL cholesterol, HDL2 and HDL3 cholesterol, and apolipoprotein A-I were reduced at higher levels of educational attainment. Apart from triglycerides in men and HDL3 cholesterol in women, these African American- white lipid differences associated with educational attainment remained statistically significant after multivariable adjustment for lifestyle factors. Lipoprotein(a) showed no association with educational attainment. These findings confirm African American-white differences in lipids, lipoproteins, and apolipoproteins across levels of educational attainment that were not explained by conventional nondietary lifestyle variables. Understanding these differences associated with educational attainment will assist in identifying measures aimed at prevention of cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)750-760
Number of pages11
JournalAmerican journal of epidemiology
Issue number8
StatePublished - Oct 15 1998

Bibliographical note

Funding Information:
Support was provided by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, NOl-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. This research was carried out by Patricia A. Metcalf during the tenure of an Overseas Research Fellowship of the Health Research Council of New Zealand. Bruce B. Duncan was supported by a fellowship from the Brazilian Ministry of Education (CAPES, Coorde-nacao de Aperfeicoamento de Pessaol de Nivel Superior). The authors thank the following persons from the ARIC field centers: Phyllis Johnson, Marilyn Knowles, and Catherine Paton of the University of North Carolina at Chapel Hill, North Carolina; Jeanette Bensen, Kay Burke, Wilhelmenia Cheeks, and Revitha Cook of the University of North Carolina, Forsyth County, North Carolina; Betty Warren, Dorothy Washington, Mattye Watson, and Nancy Wilson of the University of Mississippi Medical Center, Jackson, Mississippi; Irene Keske, Nancy MacLennan, Sandy Mechels, and Gail Murton of the University of Minnesota, Minneapolis, Minnesota; Rodney Palmer, Serena Bell, Joyce Chabot, and Carol Christman of The Johns Hopkins University, Baltimore, Maryland; Valerie Stinson, Pam Pfile, Hogan Pham, and Teri Trevino of the University of Texas Medical School, Houston, Texas; Wanda R. Alexander, Doris J. Harper, Charles E. Rhodes, and Selma M. Soyal of the Methodist Hospital, Atherosclerosis Clinical Laboratory, Houston, Texas; Nancy Bourne, Charlene Kearney-Cash, Kelli Collins, and Celilah Cook of the Bowman-Gray School of Medicine, Ultrasound Reading Center, Winston-Salem, North Carolina; Debbie Rubin-Williams, W. Brian Stewart, Chimmon Walter, and Louis Wijnberg of the Collaborative Studies Coordinating Center of the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.


  • Apoliproteins
  • Education
  • Lipids
  • Lipoproteins


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